SDTM Terminology

CDISC SDTM Controlled Terminology, 2018-09-28
Source: NCI EVS Terminology Resources website: http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/cdisc
NCI CDISC Submission Codelist Name CDISC Definition Codelist

Code Value Extensible
C141663 A4STR1TC 4 Stair Ascend Functional 4 Stair Ascend test code. No

Test Test Code
C141662 A4STR1TN 4 Stair Ascend Functional 4 Stair Ascend test name. No

Test Test Name
C103459 ACGC01TC Alzheimer's Disease Alzheimer's Disease Cooperative Study-Clinical Global Impression of No
Cooperative Study- Change test code.
Clinical Global
Impression of Change
Questionnaire Test Code
C103458 ACGC01TN Alzheimer's Disease Alzheimer's Disease Cooperative Study-Clinical Global Impression of No
Cooperative Study- Change test name.
Clinical Global
Impression of Change
Questionnaire Test Name
C66767 ACN Action Taken with Study Terminology specifying changes to the study treatment as a result of an No
Treatment adverse event.
C101865 ACSPCAT Acute Coronary A classification of the presentation of acute coronary syndrome. No
Syndrome Presentation
Category
C100132 ADCTC Alzheimer's Disease ADAS-Cog CDISC Version test code. No

Assessment Scale -
Cognitive CDISC Version
C100131 ADCTN Alzheimer's Disease ADAS-Cog CDISC Version test name. No

Assessment Scale -
Cognitive CDISC Version
C105140 ADL01TC Alzheimer's Disease Alzheimer's Disease Cooperative Study-Activities of Daily Living No
Cooperative Study- Inventory test code.
Activities of Daily Living
Inventory Questionnaire
Test Code
C105139 ADL01TN Alzheimer's Disease Alzheimer's Disease Cooperative Study-Activities of Daily Living No
Cooperative Study- Inventory test name.
Test Name
Cooperative Study- Inventory Severe Dementia Version test code.
Inventory Severe
Dementia Version
Cooperative Study- Inventory Severe Dementia Version test name.
Inventory Severe
Dementia Version
Cooperative Study- Inventory MCI Version test code.
Inventory MCI Version
Cooperative Study- Inventory MCI Version test name.
Inventory MCI Version
C119060 ADT01TC Alcohol Use Disorder Alcohol Use Disorder Identification Test: Self-Report Version test code. No
Identification Test: Self-
Report Version
C119059 ADT01TN Alcohol Use Disorder Alcohol Use Disorder Identification Test: Self-Report Version test name. No
Identification Test: Self-
Report Version
page 1 of 1925
C119062 ADTC01TC Alcohol Use Disorder Alcohol Use Disorder Identification Test-Consumption Questions test No
Identification Test- code.
Consumption Questions
C119061 ADTC01TN Alcohol Use Disorder Alcohol Use Disorder Identification Test-Consumption Questions test No
Identification Test- name.
Consumption Questions
C132311 ADTNQRS Administration Technique Terminology relevant to the product administration technique used. Yes
Response
C66769 AESEV Severity/Intensity Scale A scale that defines the degree or state of disease existing in a patient No
for Adverse Events as a result of the occurrence of an adverse event. (NCI)
C66781 AGEU Age Unit Those units of time that are routinely used to express the age of a No
subject.
C101805 AIMS01TC Abnormal Involuntary Abnormal Involuntary Movement Scale test code. No
Movement Scale
C101806 AIMS01TN Abnormal Involuntary Abnormal Involuntary Movement Scale test name. No
Movement Scale
C141655 AJCC1TC AJCC TNM Staging AJCC TNM Staging System 7th Edition test code. No
System 7th Edition
Clinical Classification
Test Code
C141654 AJCC1TN AJCC TNM Staging AJCC TNM Staging System 7th Edition test name. No
System 7th Edition
Test Name
C135012 AJCCGRD AJCC Tumor Grade Terminology relevant to the American Joint Committee on Cancer No
Response (AJCC) tumor grading system responses.
C120985 APCH1TC Acute Physiology and Acute Physiology and Chronic Health Evaluation II test code. No
Chronic Health
Evaluation II Clinical
Classification Test Code
C120984 APCH1TN Acute Physiology and Acute Physiology and Chronic Health Evaluation II test name. No
Chronic Health
Evaluation II Clinical
Classification Test Name
C112435 AQ01TC Airway Questionnaire 20 Airway Questionnaire 20 test code. No

C112434 AQ01TN Airway Questionnaire 20 Airway Questionnaire 20 test name. No

C142179 ARMNULRS Arm Null Reason Terminology relevant to the reason for why an arm and/or an actual arm Yes
is null.
C124666 ASCVD1TC Atherosclerotic Atherosclerotic Cardiovascular Disease 10-Year Risk Estimator test code. No
Cardiovascular Disease
10-Year Risk Estimator
Test Code
C124665 ASCVD1TN Atherosclerotic Atherosclerotic Cardiovascular Disease 10-Year Risk Estimator test No
Cardiovascular Disease name.
10-Year Risk Estimator
Test Name
C125741 ASEX01TC Arizona Sexual Arizona Sexual Experiences Scale - Female test code. No
Experiences Scale -
Female Questionnaire
Test Code
C125740 ASEX01TN Arizona Sexual Arizona Sexual Experiences Scale - Female test name. No
Experiences Scale -
Female Questionnaire
Test Name
C125743 ASEX02TC Arizona Sexual Arizona Sexual Experiences Scale - Male test code. No
Experiences Scale - Male
page 2 of 1925
C125742 ASEX02TN Arizona Sexual Arizona Sexual Experiences Scale - Male test name. No
Experiences Scale - Male
C132312 ASFATS Asthma Findings About Terminology relevant to the test names that describe findings about an Yes
Test Name asthma event or intervention.
C132313 ASFATSCD Asthma Findings About Terminology relevant to the test codes that describe findings about an Yes
Test Code asthma event or intervention.
C124668 ASSG01TC ASSIGN Cardiovascular ASSIGN Cardiovascular Disease 10-Year Risk Score test code. No
Disease 10-Year Risk
Score Clinical
C124667 ASSG01TN ASSIGN Cardiovascular ASSIGN Cardiovascular Disease 10-Year Risk Score test name. No
Score Clinical
C147538 ATLAS1TC ATLAS Clinical ATLAS test code. No

C147537 ATLAS1TN ATLAS Clinical ATLAS test name. No

C101807 AVL01TC ADNI Auditory Verbal ADNI AVLT test code. No

Learning Functional Test
Test Code
C101808 AVL01TN ADNI Auditory Verbal ADNI AVLT test name. No

Learning Functional Test
Test Name
C123655 AVL02TC Rey Auditory Verbal Rey Auditory Verbal Learning Test test code. No
Learning Test Functional
Test Test Code
C123654 AVL02TN Rey Auditory Verbal Rey Auditory Verbal Learning Test test name. No
Learning Test Functional
Test Test Name
C120521 AVOUTTRT Anti-Viral Outcome of A terminology codelist to describe the anti-viral outcome of treatment. Yes
Treatment
C120983 BACS1TC Brief Assessment of Brief Assessment of Cognition in Schizophrenia test code. No
Cognition in
Schizophrenia Functional
Test Test Code
C120982 BACS1TN Brief Assessment of Brief Assessment of Cognition in Schizophrenia test name. No
Cognition in
Schizophrenia Functional
Test Test Name
C101809 BARS01TC Barnes Akathisia Rating Barnes Akathisia Rating Scale test code. No
Scale Questionnaire Test
Code
C101810 BARS01TN Barnes Akathisia Rating Barnes Akathisia Rating Scale test name. No
Name
C113846 BCR101TC Borg CR10 Scale Borg CR10 scale test code. No
C113845 BCR101TN Borg CR10 Scale Borg CR10 scale test name. No
C106655 BDI01TC Baseline Dyspnea Index Baseline Dyspnea Index test code. No
C106654 BDI01TN Baseline Dyspnea Index Baseline Dyspnea Index test name. No
C135680 BEBQ01TC Baby Eating Behaviour Baby Eating Behaviour Questionnaire Concurrent Version test code. No
Questionnaire
Concurrent Version
C135679 BEBQ01TN Baby Eating Behaviour Baby Eating Behaviour Questionnaire Concurrent Version test name. No
Questionnaire
Concurrent Version
page 3 of 1925
C135682 BEBQ02TC Baby Eating Behaviour Baby Eating Behaviour Questionnaire Retrospective Version test code. No
Questionnaire
Retrospective Version
C135681 BEBQ02TN Baby Eating Behaviour Baby Eating Behaviour Questionnaire Retrospective Version test name. No
Questionnaire
Retrospective Version
C124297 BEDECOD Biospecimen Events A terminology codelist based on the verbatim or preprinted term for the Yes
Dictionary Derived Term biospecimen events that occur.
C113852 BLCS01TC Bladder Control Scale Bladder Control Scale test code. No
C113851 BLCS01TN Bladder Control Scale Bladder Control Scale test name. No
C120987 BODE01TC The Body-Mass Index, The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise No
Airflow Obstruction, Capacity Index test code.
Dyspnea, and Exercise
Capacity Index Clinical
C120986 BODE01TN The Body-Mass Index, The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise No
Airflow Obstruction, Capacity Index test name.
Dyspnea, and Exercise
Capacity Index Clinical
C100162 BPI1TC Brief Pain Inventory Brief Pain Inventory test code. No
C100161 BPI1TN Brief Pain Inventory Brief Pain Inventory test name. No
C100164 BPI2TC Brief Pain Inventory Brief Pain Inventory Short Form test code. No
Short Form
C100163 BPI2TN Brief Pain Inventory Brief Pain Inventory Short Form test name. No
Short Form
C100134 BPR01TC Brief Psychiatric Rating The Brief Psychiatric Rating Scale-A test code. No
Scale-A Questionnaire
Test Code
C100133 BPR01TN Brief Psychiatric Rating The Brief Psychiatric Rating Scale-A test name. No
Scale-A Questionnaire
Test Name
C125923 BRDGMOOD BRIDG Activity Mood The modes that may be applied to an entity as it passes through various Yes
phases of a life cycle or business process.
C124299 BSTEST Biospecimen Terminology relevant to the test names that describe the characteristics Yes
Characteristics Test of biospecimens and extracted samples.
Name
C124300 BSTESTCD Biospecimen Terminology relevant to the test codes that describe the characteristics Yes
Characteristics Test Code of biospecimens and extracted samples.
C130239 BUERS1TC Brooke Upper Extremity Brooke Upper Extremity Rating Scale test code. No
Rating Scale Clinical
C130238 BUERS1TN Brooke Upper Extremity Brooke Upper Extremity Rating Scale test name. No
C113854 BWCS01TC Bowel Control Scale Bowel Control Scale test code. No
C113853 BWCS01TN Bowel Control Scale Bowel Control Scale test name. No
C101842 CACRDSC Canadian Cardiovascular The anginal classifications as measured by the Canadian Cardiovascular No
Society Classification Society grading scale.
C119076 CADG01TC Coronary Artery Coronary Artery Dissection NHLBI Grade test code. No
Dissection NHLBI Grade
Test Code
page 4 of 1925
C119075 CADG01TN Coronary Artery Coronary Artery Dissection NHLBI Grade test name. No
Dissection NHLBI Grade
Test Name
C119018 CADGRS Coronary Artery A terminology codelist relevant to the National Heart, Lung, and Blood No
Dissection NHLBI Grade Institute grade for coronary artery dissection and perforation.
Responses
C101843 CADPRSN Coronary Artery Disease A terminology codelist associated with coronary artery disease No
Presentation presentation.
C101849 CADRISK Coronary Artery Disease A terminology codelist to describe the relative risk of coronary artery No
Risk disease.
C101844 CADSYMP Coronary Artery Disease A terminology codelist that contains symptoms associated with coronary No
Symptoms artery disease.
C101860 CARTDOM Coronary Artery A codelist to describe the pattern of the epicardial vessels supplying the No
Dominance posterior descending artery and the posterolateral branches.
C127263 CASEFIND Case Finding Terminology relevant to how actively a search was performed for Yes
identifying individuals with a particular disease.
C118971 CCCAT Category of Clinical A grouping of observations within the Disease Response and Clin Yes
Classification Classification domain.
C102575 CCINVTYP Contact Case Terminology relevant to the identification and clinical investigation of Yes
Investigation Contact disease contacts.
Type
C119064 CCQ01TC Clinical COPD Clinical COPD Questionnaire 24 Hour Version test code. No
Questionnaire 24 Hour
Version Questionnaire
Test Code
C119063 CCQ01TN Clinical COPD Clinical COPD Questionnaire 24 Hour Version test name. No
Questionnaire 24 Hour
Test Name
C119066 CCQ02TC Clinical COPD Clinical COPD Questionnaire 1 Week Version test code. No
Questionnaire 1 Week
Test Code
C119065 CCQ02TN Clinical COPD Clinical COPD Questionnaire 1 Week Version test name. No
Questionnaire 1 Week
Test Name
C101837 CCRCLS Consensus Cardiac Classification system test name for cardiac parameters that are Yes
Classification System authored or endorsed by organizations.
Test Name
C101838 CCRCLSCD Consensus Cardiac Classification system test code for cardiac parameters that are authored Yes
Classification System or endorsed by organizations.
Test Code
C150813 CDFATS CDAD Findings About Terminology relevant to the test names that describe findings about Yes
Test Name Clostridium difficile-associated diarrhea event or intervention.
C150812 CDFATSCD CDAD Findings About Terminology relevant to the test codes that describe findings about Yes
Test Code Clostridium difficile-associated diarrhea event or intervention.
C101811 CDR01TC Clinical Dementia Rating Clinical Dementia Rating test code. No
C101812 CDR01TN Clinical Dementia Rating Clinical Dementia Rating test name. No
C154447 CDRS01TC Children's Depression Children's Depression Rating Scale, Revised test code. No
Rating Scale, Revised
Test Code
C154446 CDRS01TN Children's Depression Children's Depression Rating Scale, Revised test name. No
Rating Scale, Revised
Test Name
C132519 CES01TC Combat Exposure Scale Combat Exposure Scale test code. No
page 5 of 1925
C132518 CES01TN Combat Exposure Scale Combat Exposure Scale test name. No
C135684 CGGUY1TC Clinical Global Clinical Global Impression test code. No

Impression
C135683 CGGUY1TN Clinical Global Clinical Global Impression test name. No

Impression
C135686 CGI02TC Clinical Global Clinical Global Impression Generic Modification Version test code. No
Impression Generic
Modification Version
C135685 CGI02TN Clinical Global Clinical Global Impression Generic Modification Version test name. No
Impression Generic
C124678 CHIVC1TC CDC Classification CDC Classification System for HIV-Infected Adults and Adolescents test No
System for HIV-Infected code.
Adults and Adolescents
Test Code
C124677 CHIVC1TN CDC Classification CDC Classification System for HIV-Infected Adults and Adolescents test No
System for HIV-Infected name.
Adults and Adolescents
Test Name
C117987 CHSF1TC Craig Handicap Craig Handicap Assessment and Reporting Technique - Short Form No
Assessment and Interview Version test code.
Reporting Technique -
Short Form Interview
Test Code
C117986 CHSF1TN Craig Handicap Craig Handicap Assessment and Reporting Technique - Short Form No
Assessment and Interview Version test name.
Short Form Interview
Test Name
C119068 CHSF2TC Craig Handicap Craig Handicap Assessment and Reporting Technique - Short Form No
Assessment and Paper Version test code.
Short Form Paper
Test Code
C119067 CHSF2TN Craig Handicap Craig Handicap Assessment and Reporting Technique - Short Form No
Assessment and Paper Version test name.
Short Form Paper
Test Name
C132314 CLMETH Specimen Collection Terminology relevant to the method used in specimen collection. Yes
Method
C127264 CLTMDTYP Culture Medium Type Terminology relevant to the type of medium used to culture a specimen. Yes
C100158 COMM1TC Current Opioid Misuse Current Opioid Misuse Measure test code. No
Measure Questionnaire
Test Code
C100157 COMM1TN Current Opioid Misuse Current Opioid Misuse Measure test name. No
Measure Questionnaire
Test Name
C127257 CONROL Contact Role for Clinical The terminology relevant to the role that the responsible individual or Yes
Study entity plays with respect to being a contact for the study.
C150766 COWAT1TC Controlled Oral Word Controlled Oral Word Association Test test code. No
Association Test
Functional Test Test
Code
C150765 COWAT1TN Controlled Oral Word Controlled Oral Word Association Test test name. No
Association Test
Name
page 6 of 1925
C101813 COWS1TC Clinical Opiate Clinical Opiate Withdrawal Scale test code. No
Withdrawal Scale
C101814 COWS1TN Clinical Opiate Clinical Opiate Withdrawal Scale test name. No
Withdrawal Scale
C122006 CPFATS COPD Findings About Terminology relevant to the test names that describe findings about a Yes
Test Name COPD event or intervention.
C122007 CPFATSCD COPD Findings About Terminology relevant to the test codes that describe findings about a Yes
Test Code COPD event or intervention.
C120989 CPS01TC Child-Pugh Classification Child-Pugh Classification test code. No

Test Code
C120988 CPS01TN Child-Pugh Classification Child-Pugh Classification test name. No

Test Name
C120979 CRQ01TC Chronic Respiratory Chronic Respiratory Questionnaire Self-Administered Standardized No

Questionnaire Self- Format First Administration Version test code.
Administered
Standardized Format
First Administration
Test Code
C120978 CRQ01TN Chronic Respiratory Chronic Respiratory Questionnaire Self-Administered Standardized No

Questionnaire Self- Format First Administration Version test name.
Administered
Standardized Format
First Administration
Test Name
C120981 CRQ02TC Chronic Respiratory Chronic Respiratory Questionnaire Self-Administered Standardized No

Questionnaire Self- Format Follow-Up Administration Version test code.
Administered
Standardized Format
Follow-Up Administration
Test Code
C120980 CRQ02TN Chronic Respiratory Chronic Respiratory Questionnaire Self-Administered Standardized No

Questionnaire Self- Format Follow-Up Administration Version test name.
Administered
Standardized Format
Follow-Up Administration
Test Name
C124684 CRSR01TC JFK Coma Recovery JFK Coma Recovery Scale-Revised test code. No
Scale-Revised Clinical
C124683 CRSR01TN JFK Coma Recovery JFK Coma Recovery Scale-Revised test name. No
Scale-Revised Clinical
C101866 CRYDFMAN Cardiac Rhythm Device The effect that a cardiac rhythm device malfunction had on the ability to Yes
Failure Manifestation stimulate the heart.
C101864 CSLVLNIM Reason CS/LV Lead Not The reason that a Coronary Sinus Access or Left Ventricular (CS/LV) No
Implanted lead was not implanted.
C100168 CSS01TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Baseline test code. No
Severity Rating Scale
Baseline Questionnaire
Test Code
C100167 CSS01TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Baseline test name. No
Baseline Questionnaire
Test Name
C103461 CSS02TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Since Last Visit test code. No
Since Last Visit
C103460 CSS02TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Since Last Visit test name. No
Since Last Visit
page 7 of 1925
C105132 CSS03TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Baseline/Screening Version No

Severity Rating Scale Phase 1 Study Version 1/14/2009 Questionnaire test code.
Baseline/Screening
Version Phase 1 Study
C105131 CSS03TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Baseline/Screening Version No

Severity Rating Scale Phase 1 Study Version 1/14/2009 test name.
Baseline/Screening
Version Phase 1 Study
C106661 CSS04TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Baseline/Screening Version test No
Severity Rating Scale code.
Baseline/Screening
Test Code
C106660 CSS04TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Baseline/Screening Version test No
Severity Rating Scale name.
Baseline/Screening
Test Name
C106659 CSS05TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Already Enrolled Subject test No
Already Enrolled
Subjects Questionnaire
Test Code
C106658 CSS05TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Already Enrolled Subject test No
Already Enrolled
Subjects Questionnaire
Test Name
C111336 CSS06TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Children's Baseline test code. No
Children's Baseline
C111335 CSS06TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Children's Baseline test name. No
Children's Baseline
C111338 CSS07TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Children's Baseline/Screening No

Severity Rating Scale test code.
Children's
Baseline/Screening
C111337 CSS07TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Children's Baseline/Screening No

Severity Rating Scale test name.
Children's
Baseline/Screening
C111340 CSS08TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Children's Since Last Visit test No
Children's Since Last
Visit Questionnaire Test
Code
C111339 CSS08TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Children's Since Last Visit test No
Children's Since Last
Visit Questionnaire Test
Name
C111342 CSS09TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Screening test code. No
Screening Questionnaire
Test Code
C111341 CSS09TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Screening test name. No
Screening Questionnaire
Test Name
C113848 CSS10TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Pediatric/Cognitively Impaired No

Severity Rating Scale Lifetime/Recent test code.
Pediatric/Cognitively
Impaired
Lifetime/Recent
page 8 of 1925
C113847 CSS10TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Pediatric/Cognitively Impaired No

Severity Rating Scale Lifetime/Recent test name.
Pediatric/Cognitively
Impaired
Lifetime/Recent
C117989 CSS11TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Lifetime/Recent Version test No
Lifetime/Recent Version
C117988 CSS11TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Lifetime/Recent Version test No
Lifetime/Recent Version
C119017 CTTIMIRS Coronary Thrombus TIMI A terminology codelist relevant to the Thrombolysis in Myocardial No
Grade Responses Infarction group grade for the description of coronary thrombus as
visualized during angiography.
C119016 CVFARS Cardiovascular Findings Terminology responses used for the cardiovascular findings about test No
About Results codes and names codelist within CDISC.
C119014 CVFATS Cardiovascular Findings Terminology relevant to the test names that describe findings about a No
About Test Name cardiovascular event or intervention.
C119015 CVFATSCD Cardiovascular Findings Terminology relevant to the test codes that describe findings about a No
About Test Code cardiovascular event or intervention.
C101859 CVPRCIND Cardiac Procedure The reason that a subject had a cardiac procedure. Yes
Indication
C101850 CVSLDEXT Coronary Vessel Disease A terminology codelist to describe the extent of coronary artery disease. No
Extent
C101846 CVTEST Cardiovascular Test A terminology codelist to describe the test name for a physiological Yes
Name examination of the cardiovascular system.
C101847 CVTESTCD Cardiovascular Test Code A terminology codelist to describe the test code for a physiological Yes
examination of the cardiovascular system.
C141661 D4STR1TC Descend 4 Stairs Descend 4 Stairs test code. No

Code
C141660 D4STR1TN Descend 4 Stairs Descend 4 Stairs test name. No

Name
C105130 DAD01TC Disability Assessment for Disability Assessment for Dementia test code. No
Dementia Questionnaire
Test Code
C105129 DAD01TN Disability Assessment for Disability Assessment for Dementia test name. No
Dementia Questionnaire
Test Name
C78731 DATEST Drug Accountability Test The name of the test for the drug accountability assessment. Yes
Name
C78732 DATESTCD Drug Accountability Test The short name, or code, of the test for the drug accountability Yes
Code assessment.
C111110 DEACNDEV Device Events Action A terminology codelist based on the action taken with respect to the Yes
Taken with Device device.
C111109 DECAT Category of Device A terminology codelist based on the category of related records for the Yes
Events device event.
C101857 DIABTHPY Diabetes Therapy A terminology codelist that describes the treatment method for diabetes. Yes
C66788 DICTNAM Dictionary Name A name given to a reference source that lists words and gives their Yes
meaning. (NCI)
C106480 DIPARM Device Identifier Long A terminology codelist for the long name of the identifier characteristic Yes
Name of the device.
C106481 DIPARMCD Device Identifier Short A terminology codelist for the short name of the identifier characteristic Yes
Name of the device.
C99074 DIR Directionality CDISC terminology for anatomical location or specimen further detailing Yes
directionality.
C101863 DISCHDX Discharge Disposition The destination or circumstance at the time of discharge. Yes
page 9 of 1925
C129939 DKFATS Diabetic Kidney Disease Terminology relevant to the test names that describe findings about a Yes
Findings About Test diabetic kidney disease event or intervention.
Name
C129940 DKFATSCD Diabetic Kidney Disease Terminology relevant to the test codes that describe findings about a Yes
Findings About Test diabetic kidney disease event or intervention.
Code
C119070 DLQI1TC Dermatology Life Quality Dermatology Life Quality Index test code. No
Index Questionnaire Test
Code
C119069 DLQI1TN Dermatology Life Quality Dermatology Life Quality Index test name. No
Name
C139019 DMFATS Duchenne Muscular Terminology relevant to the test cnames that describe findings about a Yes
Dystrophy Findings Duchenne muscular dystrophy event or intervention.
About Test Name
C139018 DMFATSCD Duchenne Muscular Terminology relevant to the test codes that describe findings about a Yes
Dystrophy Findings Duchenne muscular dystrophy event or intervention.
About Test Code
C66734 DOMAIN SDTM Domain A unique, 2-character domain code used in the regulatory submission Yes
Abbreviation process. The domain abbreviation is used consistently throughout the
submission, i.e. in the dataset name, as the value of the domain
variable within the dataset, and as a prefix for most variable names in
the dataset. (CDISC Glossary)
C111112 DOTEST Device Properties Test A terminology codelist based on the test name used to obtain the device Yes
Name property.
C111111 DOTESTCD Device Properties Test A terminology codelist based on the test code used to obtain the device Yes
Code property.
C141673 DRRI1TC Deployment Risk and Deployment Risk and Resilience Inventory-2 test code. No
Resilience Inventory-2
C141672 DRRI1TN Deployment Risk and Deployment Risk and Resilience Inventory-2 test name. No
Resilience Inventory-2
C115402 DRS01TC Disability Rating Scale Disability Rating Scale test code. No
C115401 DRS01TN Disability Rating Scale Disability Rating Scale test name. No
C102577 DRSTAT Drug Resistance Status Terminology relevant to the state or condition of the microbe or lesion to Yes
indicate whether it is resistant to drugs normally used in treatment.
C112437 DS01TC Disease Steps Disease Steps test code. No

C112436 DS01TN Disease Steps Disease Steps test name. No

C74558 DSCAT Category for Disposition Classifications that describe and group pertinent events that occur No
Event throughout the conduct of a clinical trial.
C127268 DSPRTYP Disease Presentation Terminology relevant to the symptoms and/or clinical manifestation of a Yes
Type disease.
C102578 DSSOUT Disease Outcome Terminology relevant to the measurable result or effect of treatment on Yes
a disease.
C112037 DTDECOD Device Tracking and A terminology codelist based on the verbatim or preprinted term for the Yes
Disposition Event device tracking and disposition event that occurs.
Dictionary Derived Term
C116107 DTHDX SDTM Death Diagnosis Terminology relevant to the test codes that describe the death diagnosis Yes
and Details Test Name and related details.
C116108 DTHDXCD SDTM Death Diagnosis Terminology relevant to the test codes that describe the death diagnosis Yes
and Details Test Code and related details.
C129938 DURS Device-In-Use Response A terminology codelist relevant to the device-in-use responses. Yes
C106482 DUTEST Device-In-Use Test A terminology codelist for the test name of the test or examination used Yes
Name to obtain the measurement or finding of the device in use.
C106483 DUTESTCD Device-In-Use Test Code A terminology codelist for the test code of the test or examination used Yes
to obtain the measurement or finding of the device in use.
page 10 of 1925
C132315 EBFATS Ebola Virus Findings Terminology relevant to the test names that describe findings about an Yes
About Test Name Ebola virus infection event or intervention.
C132316 EBFATSCD Ebola Virus Findings Terminology relevant to the test codes that describe findings about an Yes
About Test Code Ebola virus infection event or intervention.
C101815 ECOG1TC Eastern Cooperative Eastern Cooperative Oncology Group Performance Status test code. No
Oncology Group
Performance Status
C101816 ECOG1TN Eastern Cooperative Eastern Cooperative Oncology Group Performance Status test name. No
Oncology Group
Performance Status
C125745 ED1TC Expanded Disability Expanded Disability Rating Scale - Postacute Interview Caregiver No
Rating Scale - Postacute Version test code.
Interview Caregiver
Test Code
C125744 ED1TN Expanded Disability Expanded Disability Rating Scale - Postacute Interview Caregiver No
Rating Scale - Postacute Version test name.
Interview Caregiver
Test Name
C125747 ED2TC Expanded Disability Expanded Disability Rating Scale - Postacute Interview Survivor Version No
Rating Scale - Postacute test code.
Interview Survivor
Test Code
C125746 ED2TN Expanded Disability Expanded Disability Rating Scale - Postacute Interview Survivor Version No
Rating Scale - Postacute test name.
Interview Survivor
Test Name
C112439 EDSS01TC Kurtzke Expanded Kurtzke Expanded Disability Status Scale test code. No
Disability Status Scale
C112438 EDSS01TN Kurtzke Expanded Kurtzke Expanded Disability Status Scale test name. No
Disability Status Scale
C90013 EGLEAD ECG Lead Terminology related to electrocardiogram lead names. Yes
C71151 EGMETHOD ECG Test Method Terminology codelist used with ECG Test Methods within CDISC. Yes
C71150 EGSTRESC ECG Result Terminology codelist used with ECG Findings and Abnormalities within Yes
CDISC.
C71152 EGTEST ECG Test Name Terminology codelist used with ECG Test Names within CDISC. Yes
C71153 EGTESTCD ECG Test Code Terminology codelist used with ECG Tests within CDISC. Yes
C150768 EMO1TC Emotion Recognition Emotion Recognition test code. No

Code
C150767 EMO1TN Emotion Recognition Emotion Recognition test name. No

Name
C111108 EMPSTAT Employment Status Terminology relevant to the state of being engaged in an activity or Yes
service for wages or salary.
C132521 EPDS01TC Edinburgh Postnatal Edinburgh Postnatal Depression Scale test code. No
Depression Scale
C132520 EPDS01TN Edinburgh Postnatal Edinburgh Postnatal Depression Scale test name. No
Depression Scale
C127350 EPIC1TC The Expanded Prostate The Expanded Prostate Cancer Index Composite Short Form test code. No
Cancer Index Composite
Short Form
page 11 of 1925
C127349 EPIC1TN The Expanded Prostate The Expanded Prostate Cancer Index Composite Short Form test name. No
Cancer Index Composite
Short Form
C127352 EPIC2TC The Expanded Prostate The Expanded Prostate Cancer Index Composite for Clinical Practice test No
Cancer Index Composite code.
for Clinical Practice
C127351 EPIC2TN The Expanded Prostate The Expanded Prostate Cancer Index Composite for Clinical Practice test No
Cancer Index Composite name.
for Clinical Practice
C99079 EPOCH Epoch The name of the EPOCH. Yes
C100136 EQ5D01TC European Quality of Life European Quality of Life Five Dimension Three Level Scale test code. No
Five Dimension Three
Level Scale
C100135 EQ5D01TN European Quality of Life European Quality of Life Five Dimension Three Level Scale test name. No
Five Dimension Three
Level Scale
C101817 EQ5D02TC European Quality of Life European Quality of Life Five Dimension Five Level Scale test code. No
Five Dimension Five
Level Scale
C101818 EQ5D02TN European Quality of Life European Quality of Life Five Dimension Five Level Scale test name. No
Five Dimension Five
Level Scale
C117991 ESRSA1TC Extrapyramidal Extrapyramidal Symptom Rating Scale-Abbreviated test code. No

Symptom Rating Scale-
Abbreviated Clinical
C117990 ESRSA1TN Extrapyramidal Extrapyramidal Symptom Rating Scale-Abbreviated test name. No

Symptom Rating Scale-
Abbreviated Clinical
C103463 ESS01TC Epworth Sleepiness Epworth Sleepiness Scale test code. No

Code
C103462 ESS01TN Epworth Sleepiness Epworth Sleepiness Scale test name. No

Name
C66790 ETHNIC Ethnic Group A social group characterized by a distinctive social and cultural tradition No
maintained from generation to generation, a common history and origin
and a sense of identification with the group; members of the group have
distinctive features in their way of life, shared experiences and often a
common genetic heritage; these features may be reflected in their
experience of health and disease. (NCI)
C128690 ETHNICC Ethnicity As Collected A terminology codelist relevant to the ethnicity of an individual as Yes
collected on the case report form.
C78735 EVAL Evaluator The role that the individual or entity plays with respect to a specific Yes
situation or person.
C102579 EVDRETRT Supporting Evidence for Terminology relevant to the clinical evidence to support reason for re- Yes
Re-Treatment treatment of disease.
C123653 EXACT1TC Exacerbations of Chronic Exacerbations of Chronic Pulmonary Disease Tool Patient-Reported No
Pulmonary Disease Tool Outcome test code.
Patient-Reported
Outcome Questionnaire
Test Code
C123652 EXACT1TN Exacerbations of Chronic Exacerbations of Chronic Pulmonary Disease Tool Patient-Reported No
Pulmonary Disease Tool Outcome test name.
Patient-Reported
Outcome Questionnaire
Test Name
page 12 of 1925
C127354 FAC001TC The Functional The Functional Assessment of Cancer Therapy-General Version 4 test No
Assessment of Cancer code.
Therapy-General Version
4 Questionnaire Test
Code
C127353 FAC001TN The Functional The Functional Assessment of Cancer Therapy-General Version 4 test No
Assessment of Cancer name.
Therapy-General Version
Name
C129094 FAC005TC Functional Assessment of Functional Assessment of Cancer Therapy-Breast Version 4 test code. No
Cancer Therapy-Breast
Version 4 Questionnaire
Test Code
C129093 FAC005TN Functional Assessment of Functional Assessment of Cancer Therapy-Breast Version 4 test name. No
Cancer Therapy-Breast
Test Name
C154453 FAC006TC Functional Assessment of Functional Assessment of Cancer Therapy-Bladder Version 4 test code. No
Cancer Therapy-Bladder
Test Code
C154452 FAC006TN Functional Assessment of Functional Assessment of Cancer Therapy-Bladder Version 4 test name. No
Cancer Therapy-Bladder
Test Name
C150774 FAC008TC Functional Assessment of Functional Assessment of Cancer Therapy-Colorectal Version 4 test No
Cancer Therapy- code.
Colorectal Version 4
C150773 FAC008TN Functional Assessment of Functional Assessment of Cancer Therapy-Colorectal Version 4 test No
Cancer Therapy- name.
Colorectal Version 4
C130255 FAC015TC Functional Assessment of Functional Assessment of Cancer Therapy-Hepatobiliary Version 4 test No
Hepatobiliary Version 4
C130254 FAC015TN Functional Assessment of Functional Assessment of Cancer Therapy-Hepatobiliary Version 4 test No
Hepatobiliary Version 4
C150782 FAC016TC Functional Assessment of Functional Assessment of Cancer Therapy-Lung Version 4 test code. No
Cancer Therapy-Lung
Test Code
C150781 FAC016TN Functional Assessment of Functional Assessment of Cancer Therapy-Lung Version 4 test name. No
Cancer Therapy-Lung
Test Name
C130253 FAC017TC Functional Assessment of Functional Assessment of Cancer Therapy-Leukemia Version 4 test code. No
Cancer Therapy-
Leukemia Version 4
C130252 FAC017TN Functional Assessment of Functional Assessment of Cancer Therapy-Leukemia Version 4 test No
Leukemia Version 4
C130257 FAC018TC Functional Assessment of Functional Assessment of Cancer Therapy-Lymphoma Version 4 test No
Lymphoma Version 4
C130256 FAC018TN Functional Assessment of Functional Assessment of Cancer Therapy-Lymphoma Version 4 test No
Lymphoma Version 4
C127358 FAC023TC The Functional The Functional Assessment of Cancer Therapy-Prostate Version 4 test No
Assessment of Cancer code.
Therapy-Prostate Version
Code
page 13 of 1925
C127357 FAC023TN The Functional The Functional Assessment of Cancer Therapy-Prostate Version 4 test No
Assessment of Cancer name.
Therapy-Prostate Version
Name
C129092 FAC028TC National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

Cancer Cancer Therapy-Bladder Symptom Index-18 Version 2 test code.
Network/Functional
Assessment of Cancer
Therapy-Bladder
Symptom Index-18
Test Code
C129091 FAC028TN National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

Cancer Cancer Therapy-Bladder Symptom Index-18 Version 2 test name.
Network/Functional
Therapy-Bladder
Symptom Index-18
Test Name
C138221 FAC029TC Functional Assessment of Functional Assessment of Cancer Therapy-Brain Symptom Index test No
Cancer Therapy-Brain code.
Symptom Index
C138220 FAC029TN Functional Assessment of Functional Assessment of Cancer Therapy-Brain Symptom Index test No
Cancer Therapy-Brain name.
Symptom Index

Cancer Cancer Therapy-Brain Symptom Index-24 Version 2 test code.
Network/Functional
Therapy-Brain Symptom
Index-24 Version 2

Cancer Cancer Therapy-Brain Symptom Index-24 Version 2 test name.
Network/Functional
Therapy-Brain Symptom
Index-24 Version 2

Cancer Cancer Therapy-Head & Neck Symptom Index-22 Version 2 test code.
Network/Functional
Therapy-Head & Neck
Symptom Index-22
Test Code

Cancer Cancer Therapy-Head & Neck Symptom Index-22 Version 2 test name.
Network/Functional
Therapy-Head & Neck
Symptom Index-22
Test Name
C138223 FAC039TC Functional Assessment of Functional Assessment of Cancer Therapy-Kidney Symptom Index-15 No
Cancer Therapy-Kidney test code.
Symptom Index-15
C138222 FAC039TN Functional Assessment of Functional Assessment of Cancer Therapy-Kidney Symptom Index-15 No
Cancer Therapy-Kidney test name.
Symptom Index-15
C150784 FAC041TC Functional Assessment of Functional Assessment of Cancer Therapy-Kidney Symptom Index- No
Cancer Therapy-Kidney Disease-Related Symptoms Version 4 test code.
Symptom Index-
Disease-Related
Symptoms Version 4
page 14 of 1925
C150783 FAC041TN Functional Assessment of Functional Assessment of Cancer Therapy-Kidney Symptom Index- No
Cancer Therapy-Kidney Disease-Related Symptoms Version 4 test name.
Symptom Index-
Disease-Related
Symptoms Version 4

Cancer Cancer Therapy-Kidney Symptom Index-19 Version 2 test code.
Network/Functional
Therapy-Kidney
Symptom Index-19
Test Code

Cancer Cancer Therapy-Kidney Symptom Index-19 Version 2 test name.
Network/Functional
Therapy-Kidney
Symptom Index-19
Test Name
C138225 FAC043TC Functional Assessment of Functional Assessment of Cancer Therapy-Lung Symptom Index test No
Cancer Therapy-Lung code.
Symptom Index
C138224 FAC043TN Functional Assessment of Functional Assessment of Cancer Therapy-Lung Symptom Index test No
Cancer Therapy-Lung name.
Symptom Index
C129096 FAC049TC Functional Assessment of Functional Assessment of Cancer Therapy-Ovarian Symptom Index test No
Cancer Therapy-Ovarian code.
Symptom Index
C129095 FAC049TN Functional Assessment of Functional Assessment of Cancer Therapy-Ovarian Symptom Index test No
Cancer Therapy-Ovarian name.
Symptom Index

Cancer Cancer Therapy-Ovarian Symptom Index-18 Version 2 test code.
Network/Functional
Therapy-Ovarian
Symptom Index-18
Test Code

Cancer Cancer Therapy-Ovarian Symptom Index-18 Version 2 test name.
Network/Functional
Therapy-Ovarian
Symptom Index-18
Test Name
C127356 FAC052TC The National The National Comprehensive Cancer Network/Functional Assessment of No
Comprehensive Cancer Cancer Therapy-Prostate Symptom Index 17 Version 2 test code.
Network/Functional
Therapy-Prostate
Symptom Index 17
Test Code
C127355 FAC052TN The National The National Comprehensive Cancer Network/Functional Assessment of No
Comprehensive Cancer Cancer Therapy-Prostate Symptom Index 17 Version 2 test name.
Network/Functional
Therapy-Prostate
Symptom Index 17
Test Name
C150780 FAC057TC Functional Assessment of Functional Assessment of Cancer Therapy/Gynecologic Oncology Group- No
Cancer Functional Neurotoxicity Version 4 test code.
Therapy/Gynecologic
Oncology Group-
Neurotoxicity Version 4
page 15 of 1925
C150779 FAC057TN Functional Assessment of Functional Assessment of Cancer Therapy/Gynecologic Oncology Group- No
Cancer Neurotoxicity Version 4 test name.
Therapy/Gynecologic
Oncology Group-
Neurotoxicity Version 4
C147540 FAC061TC Functional Assessment of Functional Assessment of Cancer Therapy-Bone Marrow Transplant No
Cancer Therapy-Bone Version 4 test code.
Marrow Transplant
Test Code
C147539 FAC061TN Functional Assessment of Functional Assessment of Cancer Therapy-Bone Marrow Transplant No
Cancer Therapy-Bone Version 4 test name.
Marrow Transplant
Test Name
C150778 FAC062TC Functional Assessment of Functional Assessment of Cancer Therapy-Biologic Response Modifiers No
Cancer Therapy-Biologic Version 4 test code.
Response Modifiers
Test Code
C150777 FAC062TN Functional Assessment of Functional Assessment of Cancer Therapy-Biologic Response Modifiers No
Cancer Therapy-Biologic Version 4 test name.
Response Modifiers
Test Name
C150776 FAC063TC Functional Assessment of Functional Assessment of Cancer Therapy-Taxane Version 4 test code. No
Cancer Therapy-Taxane
Test Code
C150775 FAC063TN Functional Assessment of Functional Assessment of Cancer Therapy-Taxane Version 4 test name. No
Cancer Therapy-Taxane
Test Name
C147544 FAC070TC Functional Assessment of Functional Assessment of Chronic Illness Therapy-Fatigue 13-Item Scale No
Chronic Illness Therapy- Version 4 test code.
Fatigue 13-Item Scale
Test Code
C147543 FAC070TN Functional Assessment of Functional Assessment of Chronic Illness Therapy-Fatigue 13-Item Scale No
Chronic Illness Therapy- Version 4 test name.
Fatigue 13-Item Scale
Test Name
C129088 FAC071TC Functional Assessment of Functional Assessment of Chronic Illness Therapy-Fatigue Version 4 test No
Chronic Illness Therapy- code.
Fatigue Version 4
C129087 FAC071TN Functional Assessment of Functional Assessment of Chronic Illness Therapy-Fatigue Version 4 test No
Chronic Illness Therapy- name.
Fatigue Version 4
C147542 FAC084TC Functional Assessment of Functional Assessment of Chronic Illness Therapy-Dyspnea 10 Item No
Chronic Illness Therapy- Short Form test code.
Dyspnea 10 Item Short
Form Questionnaire Test
Code
C147541 FAC084TN Functional Assessment of Functional Assessment of Chronic Illness Therapy-Dyspnea 10 Item No
Chronic Illness Therapy- Short Form test name.
Dyspnea 10 Item Short
Name
C147546 FAC099TC Pediatric Functional Pediatric Functional Assessment of Chronic Illness Therapy-Fatigue test No
Assessment of Chronic code.
Illness Therapy-Fatigue
C147545 FAC099TN Pediatric Functional Pediatric Functional Assessment of Chronic Illness Therapy-Fatigue test No
Assessment of Chronic name.
Illness Therapy-Fatigue
page 16 of 1925
C154451 FAC100TC Functional Assessment of Functional Assessment of Chronic Illness Therapy-Dyspnea Scale 33 No
Chronic Illness Therapy- Item Bank test code.
Dyspnea Scale 33 Item
Bank Questionnaire Test
Code
C154450 FAC100TN Functional Assessment of Functional Assessment of Chronic Illness Therapy-Dyspnea Scale 33 No
Chronic Illness Therapy- Item Bank test name.
Dyspnea Scale 33 Item
Bank Questionnaire Test
Name
C112441 FAMS01TC Functional Assessment of Functional Assessment of Multiple Sclerosis Version 4 test code. No
Multiple Sclerosis Version
Code
C112440 FAMS01TN Functional Assessment of Functional Assessment of Multiple Sclerosis Version 4 test name. No
Multiple Sclerosis Version
Name
C111344 FAQ01TC Functional Activities Functional Activities Questionnaire test code. No

C111343 FAQ01TN Functional Activities Functional Activities Questionnaire test name. No

C111346 FAQ02TC Functional Activities Functional Activities Questionnaire-NACC Version test code. No
Questionnaire-NACC
Test Code
C111345 FAQ02TN Functional Activities Functional Activities Questionnaire-NACC Version test name. No
Questionnaire-NACC
Test Name
C124670 FCVD1TC Framingham Heart Study Framingham Heart Study Cardiovascular Disease 10-Year Risk Score No
Cardiovascular Disease test code.
10-Year Risk Score
Test Code
C124669 FCVD1TN Framingham Heart Study Framingham Heart Study Cardiovascular Disease 10-Year Risk Score No
Cardiovascular Disease test name.
10-Year Risk Score
Test Name
C103465 FIQR01TC Revised Fibromyalgia Revised Fibromyalgia Impact Questionnaire test code. No
Impact Questionnaire
C103464 FIQR01TN Revised Fibromyalgia Revised Fibromyalgia Impact Questionnaire test name. No
Impact Questionnaire
C100154 FPSR1TC Faces Pain Scale - Faces Pain Scale - Revised test code. No
Revised Questionnaire
Test Code
C100153 FPSR1TN Faces Pain Scale - Faces Pain Scale - Revised test name. No
Revised Questionnaire
Test Name
C71113 FREQ Frequency The terminology that includes terms pertaining to frequency within Yes
CDISC.
C66726 FRM Pharmaceutical Dosage The form of the completed pharmaceutical product, e.g. tablet, capsule, Yes
Form injection, elixir, suppository. Dosage form can have a significant effect
on the onset, duration and intensity of the pharmacological action of a
drug. A pharmaceutical dosage form controls the rate at which the drug
is released into the biological fluids. This release rate affects its intrinsic
absorption pattern and therefore, the bioavailability of the drug.
C113850 FSS01TC Fatigue Severity Scale Fatigue Severity Scale test code. No
C113849 FSS01TN Fatigue Severity Scale Fatigue Severity Scale test name. No
C115304 FTCAT Category of Functional A grouping of observations within the Functional Tests domain. Yes
Test
page 17 of 1925
C103467 GAD01TC Generalized Anxiety Generalized Anxiety Disorder - 7 test code. No

Disorder - 7
C103466 GAD01TN Generalized Anxiety Generalized Anxiety Disorder - 7 test name. No

Disorder - 7
C128681 GASTRO Gastrointestinal Test A terminology codelist based on the test names for physiological findings Yes
Name related to the gastrointestinal system.
C128682 GASTROCD Gastrointestinal Test A terminology codelist based on the test codes for physiological findings Yes
Code related to the gastrointestinal system.
C105138 GCGI01TC General Clinical Global General Clinical Global Impressions test code. No
Impressions
C105137 GCGI01TN General Clinical Global General Clinical Global Impressions test name. No
Impressions
C124682 GCS01TC Glasgow Coma Scale Glasgow Coma Scale NINDS Version test code. No
NINDS Version Clinical
C124681 GCS01TN Glasgow Coma Scale Glasgow Coma Scale NINDS Version test name. No
NINDS Version Clinical
C106663 GDS01TC Geriatric Depression Geriatric Depression Scale test code. No

Code
C106662 GDS01TN Geriatric Depression Geriatric Depression Scale test name. No

Name
C106665 GDS02TC Geriatric Depression Geriatric Depression Scale Short Form test code. No
Scale Short Form
C106664 GDS02TN Geriatric Depression Geriatric Depression Scale Short Form test name. No
Scale Short Form
C132317 GENRTYP Genetic Region of Terminology relevant to the classification of the genetic region under Yes
Interest Type study.
C111114 GENSMP Genetic Sample Type Terminology relevant to the type of nucleic acid which was derived from Yes
the collected sample.
C103329 GNRLOBSC General Observation Terminology related to the classification of a CDISC domain. No
Class
C115404 GOSE1TC Extended Glasgow Extended Glasgow Outcome Scale test code. No
Outcome Scale
C115403 GOSE1TN Extended Glasgow Extended Glasgow Outcome Scale test name. No
Outcome Scale
C117737 GRAFTTYP Graft Type A terminology codelist relevant to the type of graft implanted in the Yes
subject.
C101851 GRSTNLOC Location of Most Severe Terminology used to describe the part of the graft that is most severely No
Stenosis Within a Graft stenotic.
C103469 HADS01TC Hospital Anxiety and Hospital Anxiety and Depression Scale test code. No
Depression Scale
C103468 HADS01TN Hospital Anxiety and Hospital Anxiety and Depression Scale test name. No
Depression Scale
C115390 HAI01TC Hauser Ambulation Hauser Ambulation Index test code. No

Index Functional Test
Test Code
C115389 HAI01TN Hauser Ambulation Hauser Ambulation Index test name. No

Index Functional Test
Test Name
page 18 of 1925
C101819 HAMA1TC Hamilton Anxiety Rating Hamilton Anxiety Rating Scale test code. No
Scale Clinical
C101820 HAMA1TN Hamilton Anxiety Rating Hamilton Anxiety Rating Scale test name. No
Scale Clinical
C100138 HAMD1TC Hamilton Depression The Hamilton Depression Rating Scale - 17 Item test code. No
Rating Scale - 17 Item
Test Code
C100137 HAMD1TN Hamilton Depression The Hamilton Depression Rating Scale - 17 Item test name. No
Test Name
C101821 HAMD2TC Hamilton Depression Hamilton Depression Rating Scale 21-Item test code. No
Rating Scale 21-Item
Test Code
C101822 HAMD2TN Hamilton Depression Hamilton Depression Rating Scale 21-Item test name. No
Rating Scale 21-Item
Test Name
C130245 HAMD3TC Hamilton Depression Hamilton Depression Rating Scale - 24 Item test code. No
Test Code
C130244 HAMD3TN Hamilton Depression Hamilton Depression Rating Scale - 24 Item test name. No
Test Name
C130243 HAMD4TC Hamilton Depression Hamilton Depression Rating Scale - 6 Clinician Version test code. No
Rating Scale - 6 Clinician
Version Clinical
C130242 HAMD4TN Hamilton Depression Hamilton Depression Rating Scale - 6 Clinician Version test name. No
Rating Scale - 6 Clinician
Version Clinical
C130259 HAMDS1TC Hamilton Depression Hamilton Depression Rating Scale - 6 Self-Report test code. No
Rating Scale - 6 Self-
Report Questionnaire
Test Code
C130258 HAMDS1TN Hamilton Depression Hamilton Depression Rating Scale - 6 Self-Report test name. No
Rating Scale - 6 Self-
Test Name
C106667 HAQ01TC Health Assessment Health Assessment Questionnaire Disability Index With Pain Visual No
Questionnaire Disability Analog Scale test code.
Index With Pain Visual
Analog Scale
C106666 HAQ01TN Health Assessment Health Assessment Questionnaire Disability Index With Pain Visual No
Questionnaire Disability Analog Scale test name.
Index With Pain Visual
Analog Scale
C132523 HAQ02TC Health Assessment Health Assessment Questionnaire Disability Index Without Pain Visual No
Questionnaire Disability Analog Scale test code.
Index Without Pain
Visual Analog Scale
C132522 HAQ02TN Health Assessment Health Assessment Questionnaire Disability Index Without Pain Visual No
Questionnaire Disability Analog Scale test name.
Index Without Pain
Visual Analog Scale
C117746 HEPENCGR West Haven Hepatic A grading system to describe the severity of hepatic encephalopathy No
Encephalopathy Grade based on the level of mental status by the West Haven Hepatic
Encephalopathy Grade.
page 19 of 1925
C120522 HESTRESC Holter ECG Results Terminology relevant to the responses that describe Holter ECG Yes
interpretative findings.
C120524 HETEST Holter ECG Test Name Terminology relevant to the test names that describe Holter ECG Yes
C120523 HETESTCD Holter ECG Test Code Terminology relevant to the test codes that describe Holter ECG Yes
C138213 HSB01TC HAS-BLED Bleeding Risk HAS-BLED Bleeding Risk Score test code. No
Score Clinical
C138212 HSB01TN HAS-BLED Bleeding Risk HAS-BLED Bleeding Risk Score test name. No
Score Clinical
C130247 IDSC1TC Inventory of Depressive Inventory of Depressive Symptomatology Clinician-Rated Version test No
Symptomatology code.
Clinician-Rated Version
Test Code
C130246 IDSC1TN Inventory of Depressive Inventory of Depressive Symptomatology Clinician-Rated Version test No
Symptomatology name.
Test Name
C130261 IDSR1TC Inventory of Depressive Inventory of Depressive Symptomatology Self-Report Version test code. No
Symptomatology Self-
Report Version
C130260 IDSR1TN Inventory of Depressive Inventory of Depressive Symptomatology Self-Report Version test No
Symptomatology Self- name.
Report Version
C66797 IECAT Category for A collection of criteria on which subjects are evaluated and that must be No
Inclusion/Exclusion met by all study subjects. (NCI)
C103471 IIEF01TC International Index of International Index of Erectile Function test code. No
Erectile Function
C103470 IIEF01TN International Index of International Index of Erectile Function test name. No
Erectile Function
C99076 INTMODEL Intervention Model A terminology codelist relevant to the trial design developed to compare Yes
Response treatment groups.
C99078 INTTYPE Intervention Type A terminology codelist relevant to the kind of product or procedure No
Response studied in a trial.
C141671 IPAQ01TC International Physical International Physical Activity Questionnaire (August 2002) Short Last 7 No
Activity Questionnaire Days Telephone Format test code.
(August 2002) Short
Last 7 Days Telephone
Format Questionnaire
Test Code
C141670 IPAQ01TN International Physical International Physical Activity Questionnaire (August 2002) Short Last 7 No
Activity Questionnaire Days Telephone Format test name.
(August 2002) Short
Test Name
C141669 IPAQ02TC International Physical International Physical Activity Questionnaire (November 2002) Long Last No
Activity Questionnaire 7 Days Telephone Format test code.
(November 2002) Long
Test Code
C141668 IPAQ02TN International Physical International Physical Activity Questionnaire (November 2002) Long Last No
Activity Questionnaire 7 Days Telephone Format test name.
(November 2002) Long
Test Name
page 20 of 1925
C141667 IPAQ03TC International Physical International Physical Activity Questionnaire (October 2002) Long Last 7 No
Activity Questionnaire Days Self-Administered Format test code.
(October 2002) Long
Last 7 Days Self-
Administered Format
C141666 IPAQ03TN International Physical International Physical Activity Questionnaire (October 2002) Long Last 7 No
Activity Questionnaire Days Self-Administered Format test name.
(October 2002) Long
Last 7 Days Self-
Administered Format
C141665 IPAQ04TC International Physical International Physical Activity Questionnaire (August 2002) Short Last 7 No
Activity Questionnaire Days Self-Administered Format test code.
(August 2002) Short
Last 7 Days Self-
Administered Format
C141664 IPAQ04TN International Physical International Physical Activity Questionnaire (August 2002) Short Last 7 No
Activity Questionnaire Days Self-Administered Format test name.
(August 2002) Short
Last 7 Days Self-
Administered Format
C120526 ISTEST Immunogenicity Terminology relevant to the immunogenicity specimen test names of the Yes
Specimen Assessments CDISC Study Data Tabulation Model.
Test Name
C120525 ISTESTCD Immunogenicity Terminology relevant to the immunogenicity specimen test codes of the Yes
Specimen Assessments CDISC Study Data Tabulation Model.
Test Code
C113856 IVIS01TC Impact of Visual Impact of Visual Impairment Scale test code. No
Impairment Scale
C113855 IVIS01TN Impact of Visual Impact of Visual Impairment Scale test name. No
Impairment Scale
C130251 KDPI01TC Kidney Donor Profile Kidney Donor Profile Index test code. No
Index Clinical
C130250 KDPI01TN Kidney Donor Profile Kidney Donor Profile Index test name. No
Index Clinical
C112443 KFSS1TC Kurtzke Functional Kurtzke Functional Systems Scores test code. No
Systems Scores
C112442 KFSS1TN Kurtzke Functional Kurtzke Functional Systems Scores test name. No
Systems Scores
C101840 KILLIPC Killip Class Responses A terminology codelist based on the classification developed by Killip and No
Kimball, which classifies patients with myocardial infarction based on
routine physical examination parameters, such as the presence or
absence of rales, or a decreased systolic blood pressure.
C100170 KPSSTC Karnofsky Performance Karnofsky Performance Status Scale test code. No
Status Scale
C100169 KPSSTN Karnofsky Performance Karnofsky Performance Status Scale test name. No
Status Scale
C99073 LAT Laterality CDISC terminology for anatomical location or specimen further detailing Yes
the side(s) of interest.
C102580 LBSTRESC Laboratory Test Terminology relevant to the standardized results, in character format, Yes
Standard Character for laboratory tests.
Result
C67154 LBTEST Laboratory Test Name Terminology used for laboratory test names of the CDISC Study Data Yes
Tabulation Model.
C65047 LBTESTCD Laboratory Test Code Terminology used for laboratory test codes of the CDISC Study Data Yes
Tabulation Model.
page 21 of 1925
C101862 LEADABN Lead Abnormality Terminology related to the complications of cardiac lead systems. Yes
C101867 LEADSTAT Lead Status The status of the lead. Yes
C135690 LEC01TC Life Events Checklist for Life Events Checklist for DSM-5 Standard Version test code. No
DSM-5 Standard Version
C135689 LEC01TN Life Events Checklist for Life Events Checklist for DSM-5 Standard Version test name. No
DSM-5 Standard Version
C74456 LOC Anatomical Location Terminology codelist used for anatomical location within CDISC. Yes
C138215 LPPSS1TC Lansky Play-Performance Lansky Play-Performance Status Scale test code. No
Status Scale Clinical
C138214 LPPSS1TN Lansky Play-Performance Lansky Play-Performance Status Scale test name. No
Status Scale Clinical
C101861 LSNCMPX Lesion Complexity Terminology related to the risk of percutaneous coronary intervention No
for a particular lesion.
C154688 LUFATS Lung Cancer Findings Terminology relevant to the test names that describe findings about a Yes
About Test Name lung cancer event or intervention.
C154687 LUFATSCD Lung Cancer Findings Terminology relevant to the test codes that describe findings about a Yes
About Test Code lung cancer event or intervention.
C101868 LVEFMRE Left Ventricular Ejection Terminology for results of left ventricular ejection fraction assessments. Yes
Fraction Measurement
Result
C76348 MARISTAT Marital Status Response A terminology codelist relevant to a person's current conjugal status. Yes
C120528 MBTEST Microbiology Test Name Terminology relevant to the microbiology test names of the CDISC Yes
Study Data Tabulation Model.
C120527 MBTESTCD Microbiology Test Code Terminology relevant to the microbiology test codes of the CDISC Study Yes
Data Tabulation Model.
C102581 MCIDCERT Microbial Identification Terminology relevant to the degree of certainty of the correctness of a No
Certainty microbial identification test result.
C101845 MCRCSPTM Mechanical Circulatory A terminology codelist to describe the timing of mechanical circulatory No
Support Placement support placement.
Timing
C96777 MEDEVAL Medical Evaluator The individual responsible for the medical assessment. Yes
C120991 MELD01TC Model for End Stage Model for End Stage Liver Disease test code. No
Liver Disease Clinical
C120990 MELD01TN Model for End Stage Model for End Stage Liver Disease test name. No
Liver Disease Clinical
C85492 METHOD Method Method is any technique or procedure (an action) that determines how Yes
an observation or clinical finding was made.
C113858 MFIS01TC Modified Fatigue Impact Modified Fatigue Impact Scale test code. No
Code
C113857 MFIS01TN Modified Fatigue Impact Modified Fatigue Impact Scale test name. No
Name
C124301 MHEDTTYP Medical History Event Terminology relevant to the classification of the medical condition or Yes
Date Type event by which MHSTDTC is defined.
C112445 MHIS01TC Modified Hachinski Modified Hachinski Ischemic Scale-NACC Version test code. No
Ischemic Scale-NACC
Test Code
C112444 MHIS01TN Modified Hachinski Modified Hachinski Ischemic Scale-NACC Version test name. No
Ischemic Scale-NACC
Test Name
C85491 MICROORG Microorganism Microorganisms, bacteria, fungi and other organisms. Yes
page 22 of 1925
C125922 MIFTSDTL Microscopic Findings Test Terminology relevant to the additional descriptions of the test being Yes
Details performed to produce the microscopic result.
C132262 MITS SDTM Microscopic Terminology for the test names concerned with the clinical findings from Yes
Findings Test Name a specimen that are visible by microscopic analysis.
C132263 MITSCD SDTM Microscopic Terminology for the test codes concerned with the clinical findings from Yes
Findings Test Code a specimen that are visible by microscopic analysis.
C106669 MMRC01TC Modified Medical Modified Medical Research Council Dyspnea Scale test code. No
Research Council
Dyspnea Scale
C106668 MMRC01TN Modified Medical Modified Medical Research Council Dyspnea Scale test name. No
Research Council
Dyspnea Scale
C100142 MMS1TC Mini-Mental State Mini-Mental State Examination test code. No

Examination Functional
Test Test Code
C100141 MMS1TN Mini-Mental State Mini-Mental State Examination test name. No

Examination Functional
Test Test Name
C150770 MMS2TC Mini-Mental State Mini-Mental State Examination 2 Standard Version test code. No
Examination 2 Standard
Version Functional Test
Test Code
C150769 MMS2TN Mini-Mental State Mini-Mental State Examination 2 Standard Version test name. No
Examination 2 Standard
Version Functional Test
Test Name
C100152 MNSI1TC Michigan Neuropathy Michigan Neuropathy Screening Instrument test code. No
Screening Instrument
C100151 MNSI1TN Michigan Neuropathy Michigan Neuropathy Screening Instrument test name. No
Screening Instrument
C127265 MODTRN Mode of Disease The terminology relevant to the mechanism by which a disease is Yes
Transmission transmitted.
C115406 MPAI1TC Mayo-Portland Mayo-Portland Adaptability Inventory-4 test code. No

Adaptability Inventory-4
C115405 MPAI1TN Mayo-Portland Mayo-Portland Adaptability Inventory-4 test name. No

Adaptability Inventory-4
C132319 MRFATS Malaria Findings About Terminology relevant to the test names that describe findings about a Yes
Test Name malaria event or intervention.
C132320 MRFATSCD Malaria Findings About Terminology relevant to the test codes that describe findings about a Yes
Test Code malaria event or intervention.
C111348 MRS01TC Modified Rankin Scale Modified Rankin Scale test code. No
C111347 MRS01TN Modified Rankin Scale Modified Rankin Scale test name. No
C117740 MSFATS Multiple Sclerosis Terminology relevant to the test names that describe multiple sclerosis Yes
Findings About Test findings.
Name
C117741 MSFATSCD Multiple Sclerosis Terminology relevant to the test codes that describe multiple sclerosis Yes
Findings About Test findings.
Code
C113860 MSQL1TC Multiple Sclerosis Quality Multiple Sclerosis Quality of Life-54 Instrument test code. No
of Life-54 Instrument
C113859 MSQL1TN Multiple Sclerosis Quality Multiple Sclerosis Quality of Life-54 Instrument test name. No
of Life-54 Instrument
page 23 of 1925
C85495 MSRESCAT Microbiology Used to categorize the result of a finding in a standard format. No
Susceptibility Testing
Result Category
C128687 MSTEST Microbiology Terminology relevant to the test names that define microorganism Yes
Susceptibility Test Name responses to antimicrobial agents.
C128688 MSTESTCD Microbiology Terminology relevant to the test codes that define microorganism Yes
Susceptibility Test Code responses to antimicrobial agents.
C127270 MUSCTS Musculoskeletal System A terminology codelist to describe the test name for a physiological Yes
Finding Test Name examination of the musculoskeletal system.
C127269 MUSCTSCD Musculoskeletal System A terminology codelist to describe the test code for a physiological Yes
Finding Test Code examination of the musculoskeletal system.
C78738 NCF Never/Current/Former A classification of usage or experience that falls into three categories; Yes
Classification never, current, or former.
C66727 NCOMPLT Completion/Reason for The status of the subject's completion of the study or a segment of the Yes
Non-Completion study, or the reason the subject discontinued the study or segment of
the study.
C66789 ND Not Done Indicates a task, process or examination that has either not been No
initiated or completed. (NCI)
C115392 NHPT01TC Nine-Hole Peg Test Nine-Hole Peg Test test code. No
Code
C115391 NHPT01TN Nine-Hole Peg Test Nine-Hole Peg Test test name. No
Name
C101834 NORMABNM Normal Abnormal A terminology codelist to describe a normal or abnormal response. No
Response
C100144 NPI1TC Neuropsychiatric The Neuropsychiatric Inventory test code. No

Test Code
C100143 NPI1TN Neuropsychiatric The Neuropsychiatric Inventory test name. No

Test Name
C103473 NPS01TC Neuropathic Pain Scale Neuropathic Pain Scale test code. No
C103472 NPS01TN Neuropathic Pain Scale Neuropathic Pain Scale test name. No
C78736 NRIND Reference Range A description of the results relative to the normal or expected range of Yes
Indicator values.
C120993 NSA01TC Negative Symptom Negative Symptom Assessment-16 test code. No

Assessment-16 Clinical
C120992 NSA01TN Negative Symptom Negative Symptom Assessment-16 test name. No

Assessment-16 Clinical
C132517 NSAA1TC North Star Ambulatory North Star Ambulatory Assessment test code. No
Assessment Clinical
C132516 NSAA1TN North Star Ambulatory North Star Ambulatory Assessment test name. No
Assessment Clinical
C154455 NSCLC1TC Non-Small Cell Lung Non-Small Cell Lung Cancer Symptom Assessment Questionnaire v1.0 No
Cancer Symptom test code.
Assessment
Questionnaire v1.0
C154454 NSCLC1TN Non-Small Cell Lung Non-Small Cell Lung Cancer Symptom Assessment Questionnaire v1.0 No
Cancer Symptom test name.
Assessment
Questionnaire v1.0
C101855 NSYSPCID Non-system Reason for A terminology codelist that contains reasons for non-system PCI delay. No
PCI Delay
page 24 of 1925
C154686 NTFATS Nutrition Findings About Terminology relevant to the test names that describe findings about a Yes
Test Name nutrition event or intervention.
C154685 NTFATSCD Nutrition Findings About Terminology relevant to the test codes that describe findings about a Yes
Test Code nutrition event or intervention.
C116103 NVTEST Nervous System Findings Terminology relevant to the test names that describe nervous system Yes
Test Name physiology findings.
C116104 NVTESTCD Nervous System Findings Terminology relevant to the test codes that describe nervous system Yes
Test Code physiology findings.
C66742 NY No Yes Response A term that is used to indicate a question with permissible values of No
yes/no/unknown/not applicable.
C101839 NYHAC New York Heart A terminology codelist based on the functional classification developed No
Association Classification by the New York Heart Association (NYHA), for categorizing patients
with defined or presumed cardiac disease.
C103475 OABQ01TC The Overactive Bladder The Overactive Bladder Questionnaire test code. No
Questionnaire
C103474 OABQ01TN The Overactive Bladder The Overactive Bladder Questionnaire test name. No
Questionnaire
C103477 OABQ02TC The Overactive Bladder The Overactive Bladder Questionnaire Short Form test code. No
Questionnaire Short
Code
C103476 OABQ02TN The Overactive Bladder The Overactive Bladder Questionnaire Short Form test name. No
Questionnaire Short
Name
C127258 OBSSBSR Observational Study The terminology relevant to whether biospecimens were retained and Yes
Biospecimen Retention contain DNA within an observational study.
C127259 OBSSMO Observational Study The terminology relevant to the trial design for observational studies. Yes
Model
C127260 OBSSSM Observational Study The terminology relevant to the method by which the study population is Yes
Sampling Method selected in an observational study.
C127261 OBSSTP Observational Study The terminology relevant to the temporal relationship between the Yes
Time Perspective observation period and time of subject enrollment in an observational
study.
C103479 ODI01TC The Oswestry Disability The Oswestry Disability Index Version 2.1a test code. No
Index Version 2.1a
C103478 ODI01TN The Oswestry Disability The Oswestry Disability Index Version 2.1a test name. No
Index Version 2.1a
C119013 OEFOCUS Ophthalmic Focus of Terminology relevant to the identification of a focus of ophthalmic No
Study Specific Interest observations.
C117742 OETEST Ophthalmic Exam Test Terminology relevant to the test names that describe findings from Yes
Name ophthalmic examinations.
C117743 OETESTCD Ophthalmic Exam Test Terminology relevant to the test codes that describe findings from Yes
Code ophthalmic examinations.
C124298 ONCRSCAT Category of Oncology The named criteria used for the grouping of assessments of response to Yes
Response Assessment treatment or therapy observations for oncology studies within the
Disease Response and Clinical Classification domain.
C96785 ONCRSR Oncology Response Terminology for oncology studies relevant to the result of response to Yes
Assessment Result treatment or therapy assessment within the disease response and
clinical classification domain.
C96781 ONCRTS Oncology Response Terminology for oncology studies relevant to the test names that Yes
Assessment Test Name describe an assessment of response to treatment or therapy within the
disease response and clinical classification domain.
C96782 ONCRTSCD Oncology Response Terminology for oncology studies relevant to the test codes that Yes
Assessment Test Code describe an assessment of response to treatment or therapy within the
disease response and clinical classification domain.
C150811 OTHEVENT Other Disposition Event A terminology codelist relevant to other important events that occur Yes
Response during a trial but are not driven by protocol requirements.
page 25 of 1925
C66768 OUT Outcome of Event A condition or event that is attributed to the adverse event and is the No
result or conclusion of the adverse event. (NCI)
C124686 PANSS1TC Positive and Negative Positive and Negative Syndrome Scale test code. No
Syndrome Scale Clinical
C124685 PANSS1TN Positive and Negative Positive and Negative Syndrome Scale test name. No
Syndrome Scale Clinical
C115394 PASAT1TC Paced Auditory Serial Paced Auditory Serial Addition Test test code. No
Addition Test Functional
Test Test Code
C115393 PASAT1TN Paced Auditory Serial Paced Auditory Serial Addition Test test name. No
Addition Test Functional
Test Test Name
C135678 PASI01TC Psoriasis Area and Psoriasis Area and Severity Index test code. No
Severity Index Clinical
C135677 PASI01TN Psoriasis Area and Psoriasis Area and Severity Index test name. No
Severity Index Clinical
C114119 PBSTMT Pharmacogenomics A terminology codelist relevant to the medical conclusion such as Yes
Biomarker Medical confirmation of a diagnosis or drug resistance based on genetic
Statement biological markers.
C135692 PCL01TC The PTSD Checklist for The PTSD Checklist for DSM-5 test code. No
DSM-5 Questionnaire
Test Code
C135691 PCL01TN The PTSD Checklist for The PTSD Checklist for DSM-5 test name. No
DSM-5 Questionnaire
Test Name
C112447 PDDS01TC Patient Determined Patient Determined Disease Steps test code. No
Disease Steps
C112446 PDDS01TN Patient Determined Patient Determined Disease Steps test name. No
Disease Steps
C116105 PFTEST Pharmacogenomics Terminology relevant to the test names that describe Yes
Findings Test Name pharmacogenomics findings.
C116106 PFTESTCD Pharmacogenomics Terminology relevant to the test codes that describe pharmacogenomics Yes
Findings Test Code findings.
C135688 PGI01TC Patient Global Patient Global Impression Generic Modification Version test code. No
Impression Generic
C135687 PGI01TN Patient Global Patient Global Impression Generic Modification Version test name. No
Impression Generic
C135011 PGTST Pharmacogenomics/Gene A terminology codelist to describe the test name/code for omics data Yes
tics Methods and methods and supporting information.
Supporting Information
Test Name
C135010 PGTSTCD Pharmacogenomics/Gene A terminology codelist to describe the test name/code for omics data Yes
tics Methods and methods and supporting information.
Supporting Information
Test Code
C103481 PHQ01TC Patient Health Patient Health Questionnaire - 9 test code. No

Questionnaire - 9 Item
C103480 PHQ01TN Patient Health Patient Health Questionnaire - 9 test name. No

C103483 PHQ02TC Patient Health Patient Health Questionnaire - 15 test code. No

page 26 of 1925
C103482 PHQ02TN Patient Health Patient Health Questionnaire - 15 test name. No

C125749 PHQ03TC Patient Health Patient Health Questionnaire Screener Version test code. No
Questionnaire Screener
Test Code
C125748 PHQ03TN Patient Health Patient Health Questionnaire Screener Version test name. No
Questionnaire Screener
Test Name
C95120 PHSPRP Physical Properties Test Terminology relevant to the test names that describe the physical Yes
Name characteristics of an entity.
C95121 PHSPRPCD Physical Properties Test Terminology relevant to the test codes that describe the physical Yes
Code characteristics of an entity.
C105134 PI01TC Pain Intensity Pain Intensity test code. No

C105133 PI01TN Pain Intensity Pain Intensity test name. No

C85493 PKPARM PK Parameters Parameters used to describe the time-concentration curve. Yes
C85839 PKPARMCD PK Parameters Code Parameter codes used to describe the time-concentration curve. Yes
C128685 PKUDMG PK Units of Measure - Units of measure for pharmacokinetic parameters normalized by dose Yes
Dose mg amount in milligrams.
C128686 PKUDUG PK Units of Measure - Units of measure for pharmacokinetic parameters normalized by dose Yes
Dose ug amount in micrograms.
C85494 PKUNIT PK Units of Measure Units of measure for pharmacokinetic data and parameters. Yes
C128684 PKUWG PK Units of Measure - Units of measure for pharmacokinetic parameters normalized by weight Yes
Weight g in grams.
C128683 PKUWKG PK Units of Measure - Units of measure for pharmacokinetic parameters normalized by weight Yes
Weight kg in kilograms.
C135694 PODCI1TC Pediatric Outcomes Data Pediatric Outcomes Data Collection Instrument, Pediatric Parent- No
Collection Instrument, Reported Version test code.
Pediatric Parent-
Reported Version
C135693 PODCI1TN Pediatric Outcomes Data Pediatric Outcomes Data Collection Instrument, Pediatric Parent- No
Collection Instrument, Reported Version test name.
Pediatric Parent-
Reported Version
C135696 PODCI2TC Pediatric Outcomes Data Pediatric Outcomes Data Collection Instrument, Adolescent Parent- No
Adolescent Parent-
Reported Version
C135695 PODCI2TN Pediatric Outcomes Data Pediatric Outcomes Data Collection Instrument, Adolescent Parent- No
Adolescent Parent-
Reported Version
C135698 PODCI3TC Pediatric Outcomes Data Pediatric Outcomes Data Collection Instrument, Adolescent Self- No
Adolescent Self-Reported
Test Code
C135697 PODCI3TN Pediatric Outcomes Data Pediatric Outcomes Data Collection Instrument, Adolescent Self- No
Adolescent Self-Reported
Test Name
C99075 PORTOT Portion/Totality Qualifier for anatomical location or specimen further detailing the Yes
portion or totality, which means arrangement of, or apportioning of an
entity.
C71148 POSITION Position Terminology codelist used with Body Position within CDISC. Yes
page 27 of 1925
C138259 PQL01TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Young Adult No
Neuromuscular Module test code.
Version 3 Young Adult
C138258 PQL01TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Young Adult No
Neuromuscular Module test name.
C138253 PQL02TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Young Adult No
Neuromuscular Module Parent Report test code.
Parent Report
C138252 PQL02TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Young Adult No
Neuromuscular Module Parent Report test name.
Parent Report
C138257 PQL03TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Teen test code. No
Neuromuscular Module
Version 3 Teen
C138256 PQL03TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Teen test No
Neuromuscular Module name.
Version 3 Teen
C138251 PQL04TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Teen Parent No
Neuromuscular Module Report test code.
Version 3 Teen Parent
Test Code
C138250 PQL04TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Teen Parent No
Neuromuscular Module Report test name.
Version 3 Teen Parent
Test Name
C138245 PQL05TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Child test code. No
Neuromuscular Module
Version 3 Child
C138244 PQL05TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Child test No
Version 3 Child
C138249 PQL06TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Child Parent No
Version 3 Child Parent
Test Code
C138248 PQL06TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Child Parent No
Version 3 Child Parent
Test Name
C138261 PQL07TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Young Child No
Version 3 Young Child
C138260 PQL07TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Young Child No
C138255 PQL08TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Young Child No
Parent Report
C138254 PQL08TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Young Child No
Parent Report
page 28 of 1925
C138247 PQL09TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Toddler Parent No
Version 3 Toddler Parent
Test Code
C138246 PQL09TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Version 3 Toddler Parent No
Version 3 Toddler Parent
Test Name
C138241 PQL10TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Young No
Neuromuscular Module Adult test code.
Acute Version 3 Young
Adult Questionnaire Test
Code
C138240 PQL10TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Young No
Neuromuscular Module Adult test name.
Adult Questionnaire Test
Name
Neuromuscular Module Adult Parent Report test code.
Adult Parent Report
Neuromuscular Module Adult Parent Report test name.
Adult Parent Report
C138239 PQL12TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Teen test No
Neuromuscular Module code.
Acute Version 3 Teen
C138238 PQL12TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Teen test No
C138233 PQL13TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Teen No
Parent Report
C138232 PQL13TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Teen No
Parent Report
C138227 PQL14TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Child No
Acute Version 3 Child
C138226 PQL14TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Child No
C138231 PQL15TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Child No
Parent Report
C138230 PQL15TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Child No
Parent Report
Neuromuscular Module Child test code.
Child Questionnaire Test
Code
page 29 of 1925
Neuromuscular Module Child test name.
Child Questionnaire Test
Name
Neuromuscular Module Child Parent Report test code.
Child Parent Report
Neuromuscular Module Child Parent Report test name.
Child Parent Report
C138229 PQL18TC Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Toddler No
Acute Version 3 Toddler
Parent Report
C138228 PQL18TN Pediatric Quality of Life Pediatric Quality of Life Neuromuscular Module Acute Version 3 Toddler No
Acute Version 3 Toddler
Parent Report
C105136 PR01TC Pain Relief Questionnaire Pain Relief test code. No

Test Code
C105135 PR01TN Pain Relief Questionnaire Pain Relief test name. No

Test Name
C102582 PRITBCON Priority of Tuberculosis Terminology relevant to the prioritization of tuberculosis contacts. Yes
Contact
C101858 PROCEDUR Procedure A terminology codelist to describe any activity considered to be a Yes
therapeutic or diagnostic procedure.
C127360 PROS01TC The Prostate Cancer The Prostate Cancer Specific Quality of Life Instrument test code. No
Specific Quality of Life
Instrument
C127359 PROS01TN The Prostate Cancer The Prostate Cancer Specific Quality of Life Instrument test name. No
Specific Quality of Life
Instrument
C114118 PROTMLST Protocol Milestone A terminology codelist relevant to protocol-specified, point-in-time Yes
events during a study.
C101856 PRURGNCY Procedure Urgency A terminology codelist that describes the degree of urgency for a No
Status procedure.
C150772 PTAP1TC Paced Tapping Functional Paced Tapping test code. No

Test Test Code
C150771 PTAP1TN Paced Tapping Functional Paced Tapping test name. No

Test Test Name
C138217 PUL01TC Performance of the Performance of the Upper Limb Module for DMD Version 1.2 test code. No
Upper Limb Module for
DMD Version 1.2
Code
C138216 PUL01TN Performance of the Performance of the Upper Limb Module for DMD Version 1.2 test name. No
DMD Version 1.2
Name
C138219 PUL02TC Performance of the Performance of the Upper Limb Module for DMD Version 2.0 test code. No
DMD Version 2.0
Code
page 30 of 1925
C138218 PUL02TN Performance of the Performance of the Upper Limb Module for DMD Version 2.0 test name. No
DMD Version 2.0
Name
C130249 QIDSC1TC Quick Inventory of Quick Inventory of Depressive Symptomatology Clinician-Rated Version No
Depressive test code.
Symptomatology
Test Code
C130248 QIDSC1TN Quick Inventory of Quick Inventory of Depressive Symptomatology Clinician-Rated Version No
Depressive test name.
Symptomatology
Test Name
C130263 QIDSR1TC Quick Inventory of Quick Inventory of Depressive Symptomatology Self-Report Version test No
Depressive code.
Report Version
C130262 QIDSR1TN Quick Inventory of Quick Inventory of Depressive Symptomatology Self-Report Version test No
Depressive name.
Report Version
C130265 QLES1TC Quality Of Life Quality Of Life Enjoyment And Satisfaction Questionnaire test code. No
Enjoyment And
Satisfaction
C130264 QLES1TN Quality Of Life Quality Of Life Enjoyment And Satisfaction Questionnaire test name. No
Enjoyment And
Satisfaction
C130267 QLES2TC Quality Of Life Quality Of Life Enjoyment And Satisfaction Questionnaire - Short Form No
Enjoyment And test code.
Satisfaction
Questionnaire - Short
Form Test Code
C130266 QLES2TN Quality Of Life Quality Of Life Enjoyment And Satisfaction Questionnaire - Short Form No
Enjoyment And test name.
Satisfaction
Questionnaire - Short
Form Test Name
C100129 QSCAT Category of A grouping of observations within the Questionnaires domain. Yes
Questionnaire
C113862 R3601TC RAND 36-Item Health RAND 36-Item Health Survey 1.0 test code. No
Survey 1.0
C113861 R3601TN RAND 36-Item Health RAND 36-Item Health Survey 1.0 test name. No
Survey 1.0
C74457 RACE Race Terminology codelist used to identify the race of an individual within the No
Clinical Data Interchange Standards Consortium Study Data Tabulation
Model.
C128689 RACEC Race As Collected A terminology codelist relevant to the race of an individual as collected Yes
on the case report form.
C124672 RCVD01TC Reynolds Cardiovascular Reynolds Cardiovascular Disease 10-Year Risk Score test code. No
Score Clinical
C124671 RCVD01TN Reynolds Cardiovascular Reynolds Cardiovascular Disease 10-Year Risk Score test name. No
Score Clinical
C100166 RDQ01TC Roland Morris Disability Roland Morris Disability Questionnaire test code. No
Questionnaire
page 31 of 1925
C100165 RDQ01TN Roland Morris Disability Roland Morris Disability Questionnaire test name. No
Questionnaire
C102583 REASTINT Reason for Treatment Terminology relevant to the reason the drug or therapy was temporarily Yes
Interruption ceased.
C102584 REASTRT Reason For Treatment Terminology relevant to the reason the treatment was administered. Yes
C100130 RELSUB Relationship to Subject The relationship of a person to a study subject. Yes
C78737 RELTYPE Relationship Type The description of relationship types between a record or set of records. No
C111107 RETEST Respiratory Test Name A terminology codelist based on the test names for physiological findings Yes
related to the respiratory system, including the organs that are involved
in breathing such as the nose, throat, larynx, trachea, bronchi and
lungs.
C111106 RETESTCD Respiratory Test Code A terminology codelist based on the test codes for physiological findings Yes
related to the respiratory system, including the organs that are involved
in breathing such as the nose, throat, larynx, trachea, bronchi and
lungs.
C141659 RISEF1TC Rising From Floor Rising From Floor test code. No
Code
C141658 RISEF1TN Rising From Floor Rising From Floor test name. No
Name
C102587 RISKSOC Social Risk Factor Terminology relevant to the social factors such as personal behavior, Yes
lifestyle, or environment belonging to the subject which are known to
increase the likelihood of infection and disease.
C66729 ROUTE Route of Administration A terminology codelist relevant to the course by which a substance is Yes
Response administered in order to reach the site of action in the body.
C119072 RPQ01TC Rivermead Post Rivermead Post Concussion Symptoms Questionnaire test code. No
Concussion Symptoms
Questionnaire
C119071 RPQ01TN Rivermead Post Rivermead Post Concussion Symptoms Questionnaire test name. No
Concussion Symptoms
Questionnaire
C106478 RPTEST Reproductive System A terminology codelist for the physiological test names related to the Yes
Findings Test Name male and female reproductive systems.
C106479 RPTESTCD Reproductive System A terminology codelist for the physiological test codes related to the Yes
Findings Test Code male and female reproductive systems.
C101848 RSKASMT Risk Assessment A terminology codelist to describe the risk of a disease, disorder or No
abnormal condition.
C135700 RSSS01TC RAND Social Support RAND Social Support Survey Instrument test code. No
Survey Instrument
C135699 RSSS01TN RAND Social Support RAND Social Support Survey Instrument test name. No
Survey Instrument
C103330 SCTEST Subject Characteristic The test name representing each subject characteristic. Yes
Test Name
C74559 SCTESTCD Subject Characteristic The test code representing each subject characteristic. Yes
Test Code
C115396 SDMT01TC Symbol Digit Modalities Symbol Digit Modalities Test test code. No
Test Functional Test Test
Code
C115395 SDMT01TN Symbol Digit Modalities Symbol Digit Modalities Test test name. No
Test Functional Test Test
Name
C111350 SDS01TC Sheehan Disability Scale Sheehan Disability Scale test code. No
C111349 SDS01TN Sheehan Disability Scale Sheehan Disability Scale test name. No
page 32 of 1925
C101852 SDTHSDTP Sudden Death Syndrome A terminology codelist that describes syndromes or conditions that put a No
Type subject at risk for sudden death.
C127262 SETTING Environmental Setting Terminology relevant to the surroundings or environment. Yes
C66731 SEX Sex The assemblage of physical properties or qualities by which male is No
distinguished from female; the physical difference between male and
female; the distinguishing peculiarity of male or female. (NCI)
C66732 SEXPOP Sex of Participants A terminology codelist relevant to the specific sex, either male, female, No
Response or mixed of the subject group being studied.
C100156 SFMP2TC Short-Form McGill Pain Short-Form McGill Pain Questionnaire-2 test code. No
Questionnaire-2
C100155 SFMP2TN Short-Form McGill Pain Short-Form McGill Pain Questionnaire-2 test name. No
Questionnaire-2
C112449 SGRQ01TC St. George's Respiratory St. George's Respiratory Questionnaire Past 3 Months Version test code. No
Questionnaire Past 3
Months Version
C112448 SGRQ01TN St. George's Respiratory St. George's Respiratory Questionnaire Past 3 Months Version test No
Questionnaire Past 3 name.
Months Version
C112451 SGRQ02TC St. George's Respiratory St. George's Respiratory Questionnaire Past 4 Weeks Version test code. No
Weeks Version
C112450 SGRQ02TN St. George's Respiratory St. George's Respiratory Questionnaire Past 4 Weeks Version test name. No
Weeks Version
C106671 SGRQC1TC St. George's Respiratory St. George's Respiratory Questionnaire for COPD Patients test code. No
Questionnaire for COPD
Patients Questionnaire
Test Code
C106670 SGRQC1TN St. George's Respiratory St. George's Respiratory Questionnaire for COPD Patients test name. No
Questionnaire for COPD
Patients Questionnaire
Test Name
C150790 SIQ01TC Suicidal Ideation Suicidal Ideation Questionnaire test code. No

C150789 SIQ01TN Suicidal Ideation Suicidal Ideation Questionnaire test name. No

C150792 SIQ02TC Suicidal Ideation Suicidal Ideation Questionnaire-JR test code. No

Questionnaire-JR
C150791 SIQ02TN Suicidal Ideation Suicidal Ideation Questionnaire-JR test name. No

Questionnaire-JR
C103485 SIQR01TC Symptom Impact Symptom Impact Questionnaire test code. No

Questionnaire
C103484 SIQR01TN Symptom Impact Symptom Impact Questionnaire test name. No

Questionnaire
C115388 SIXMW1TC 6 Minute Walk Functional 6 Minute Walk Test test code. No
Test Test Code
C115387 SIXMW1TN 6 Minute Walk Functional 6 Minute Walk Test test name. No
Test Test Name
C66733 SIZE Size Response A terminology codelist relevant to the physical magnitude of something. Yes
C76351 SKINCLAS Fitzpatrick Skin A terminology codelist relevant to the classification system used to Yes
Classification Response categorize the sensitivity of a subject's skin to sunlight. (Fitzpatrick TB.
The validity and practicality of sun-reactive skin types I through VI.
Arch. Dermatol. 1998 124: 869-871.)
page 33 of 1925
C74561 SKINTYP Skin Type Response A terminology codelist relevant to the relative oiliness of the skin. Yes
C154457 SMDDS1TC Symptoms of Major Symptoms of Major Depressive Disorder Scale v1.0 test code. No
Depressive Disorder
Scale v1.0 Questionnaire
Test Code
C154456 SMDDS1TN Symptoms of Major Symptoms of Major Depressive Disorder Scale v1.0 test name. No
Depressive Disorder
Scale v1.0 Questionnaire
Test Name
C100160 SOAPR1TC Screener and Opioid Screener and Opioid Assessment for Patients with Pain - Revised test No
Assessment for Patients code.
with Pain - Revised
C100159 SOAPR1TN Screener and Opioid Screener and Opioid Assessment for Patients with Pain - Revised test No
Assessment for Patients name.
with Pain - Revised
C101828 SOWSA1TC Subjective Opiate Subjective Opiate Withdrawal Scale test code. No
Withdrawal Scale
C101829 SOWSA1TN Subjective Opiate Subjective Opiate Withdrawal Scale test name. No
Withdrawal Scale
C116111 SPCIES SDTM Species Terminology relevant to the species of the pathogen to which the Yes
subject is a host when the pathogen is the focus of the test or
interpretation.
C78733 SPECCOND Specimen Condition The physical state or quality of a biological specimen. Yes
C78734 SPECTYPE Specimen Type The name and description of a biological specimen. Yes
C112023 SRTEST Skin Response Test A terminology codelist based on the test names for dermal responses to Yes
Name antigens.
C112024 SRTESTCD Skin Response Test Code A terminology codelist based on the test codes for dermal responses to Yes
antigens.
C124304 SSTATRS Subject Status Response Terminology relevant to subject status responses. Yes
C124306 SSTEST Subject Status Test Terminology relevant to test name for subject characteristics that are Yes
Name evaluated periodically to determine if they have changed.
C124305 SSTESTCD Subject Status Test Code Terminology relevant to test code for subject characteristics that are Yes
evaluated periodically to determine if they have changed.
C119020 STCARCRS Stent Thrombosis, A terminology codelist relevant to the Academic Research Council grade No
Coronary ARC Grade for the probability that coronary artery stent thrombosis has occurred.
Responses
C119080 STCG01TC Stent Thrombosis Stent Thrombosis Coronary ARC Grade test code. No
Coronary ARC Grade
Test Code
C119079 STCG01TN Stent Thrombosis Stent Thrombosis Coronary ARC Grade test name. No
Coronary ARC Grade
Test Name
C119019 STCTIMRS Stent Thrombosis, A terminology codelist relevant to the Academic Research Council grade No
Coronary, ARC Timing for the timing of the stent thrombosis after stent implantation.
Responses
C66728 STENRF Relation to Reference The relative relationship of a timepoint to a reference timepoint. No
Period
C99077 STYPE Study Type Response A terminology codelist relevant to the role the study plays in No
determining the interventions a subject receives.
C115408 SWLS01TC Satisfaction With Life Satisfaction With Life Scale test code. No
Code
C115407 SWLS01TN Satisfaction With Life Satisfaction With Life Scale test name. No
Name
page 34 of 1925
C124303 SZFATS Schizophrenia Findings Terminology relevant to the test names that describe findings about a Yes
About Test Name schizophrenia event or intervention.
C124302 SZFATSCD Schizophrenia Findings Terminology relevant to the test codes that describe findings about a Yes
About Test Code schizophrenia event or intervention.
C115398 T25FW1TC Timed 25-Foot Walk Test Timed 25-Foot Walk Test test code. No
Code
C115397 T25FW1TN Timed 25-Foot Walk Test Timed 25-Foot Walk Test test name. No
Name
C124664 TANN01TC Tanner Scale Girl Clinical Tanner Scale Girl test code. No
C124663 TANN01TN Tanner Scale Girl Clinical Tanner Scale Girl test name. No
C124662 TANN02TC Tanner Scale Boy Clinical Tanner Scale Boy test code. No
C124661 TANN02TN Tanner Scale Boy Clinical Tanner Scale Boy test name. No
C127267 TBFATS Tuberculosis Findings Terminology relevant to the test names that describe findings about a Yes
About Test Name tuberculosis event or intervention.
C127266 TBFATSCD Tuberculosis Findings Terminology relevant to the test codes that describe findings about a Yes
About Test Code tuberculosis event or intervention.
C66735 TBLIND Trial Blinding Schema A terminology codelist relevant to the type of blinding for the trial. Yes
Response
C66785 TCNTRL Control Type Response A terminology codelist relevant to a comparator against which the study Yes
treatment is evaluated.
C106657 TDI01TC Transition Dyspnea Transition Dyspnea Index test code. No

Code
C106656 TDI01TN Transition Dyspnea Transition Dyspnea Index test name. No

Name
C66787 TDIGRP Diagnosis Group A terminology codelist relevant to a grouping of individuals on the basis Yes
Response of a shared procedure or disease, or lack therof.
C141657 TENMW1TC Ten Meter Walk/Run Ten Meter Walk/Run test code. No
Code
C141656 TENMW1TN Ten Meter Walk/Run Ten Meter Walk/Run test name. No
Name
C119074 TIMG01TC Coronary Thrombus TIMI Coronary Thrombus TIMI Grade test code. No
Grade Clinical
C119073 TIMG01TN Coronary Thrombus TIMI Coronary Thrombus TIMI Grade test name. No
Grade Clinical
C101841 TIMIFLRS TIMI Flow Responses A terminology codelist of acceptable values to describe TIMI Flow. No
C66736 TINDTP Trial Intent Type A terminology codelist relevant to the responses for the planned purpose Yes
Response of the therapy, device, or agent under study in the clinical trial.
C124688 TMT01TC Trail Making Test Trail Making Test test code. No
Code
C124687 TMT01TN Trail Making Test Trail Making Test test name. No
Name
C66737 TPHASE Trial Phase Response A terminology codelist relevant to the phase, or stage, of the clinical Yes
trial.
C124309 TRPROPRS Tumor or Lesion Terminology relevant to the results from the assessment or Yes
Properties Test Result measurement of a tumor, lesion or site of disease.
page 35 of 1925
C96778 TRTEST Tumor or Lesion Terminology relevant to the test names that describe the assessment or Yes
Properties Test Name measurement of a tumor, lesion or site of disease.
C96779 TRTESTCD Tumor or Lesion Terminology relevant to the test codes that describe the assessment or Yes
Properties Test Code measurement of a tumor, lesion or site of disease.
C124307 TRTINTNT Treatment Intent Terminology relevant to the intended disease outcome for which the Yes
treatment is given.
C124308 TRTSET Treatment Setting Terminology relevant to the clinical trial or treatment setting for the Yes
therapy of interest.
C147548 TSCC01TC Trauma Symptom Trauma Symptom Checklist for Children test code. No
Checklist for Children
C147547 TSCC01TN Trauma Symptom Trauma Symptom Checklist for Children test name. No
Checklist for Children
C147550 TSCYC1TC Trauma Symptom Trauma Symptom Checklist for Young Children test code. No
Checklist for Young
Children Questionnaire
Test Code
C147549 TSCYC1TN Trauma Symptom Trauma Symptom Checklist for Young Children test name. No
Checklist for Young
Children Questionnaire
Test Name
C67152 TSPARM Trial Summary The test name for an individual characteristic of a clinical trial, e.g. Yes
Parameter Test Name description of trial design, trial blinding schema, and primary objective
of trial.
C66738 TSPARMCD Trial Summary The test code for an individual characteristic of a clinical trial, e.g. Yes
Parameter Test Code description of trial design, trial blinding schema, and primary objective
of trial.
C132525 TSQM01TC Treatment Satisfaction Treatment Satisfaction Questionnaire for Medication Version 1.4 test No
Questionnaire for code.
Medication Version 1.4
C132524 TSQM01TN Treatment Satisfaction Treatment Satisfaction Questionnaire for Medication Version 1.4 test No
Questionnaire for name.
Medication Version 1.4
C66739 TTYPE Trial Type Response A terminology codelist relevant to the type of primary outcome or Yes
endpoint that the protocol is designed to evaluate.
C115400 TUG01TC Timed Up and Go Test Timed Up and Go Test test code. No
Code
C115399 TUG01TN Timed Up and Go Test Timed Up and Go Test test name. No
Name
C123650 TUIDRS Tumor or Lesion Terminology relevant to tumor or lesion identification test results. Yes
Identification Test
Results
C96783 TUTEST Tumor or Lesion Terminology relevant to the test names that describe tumor or lesion Yes
Identification Test Name assessments for identification purposes.
C96784 TUTESTCD Tumor or Lesion Terminology relevant to the test codes that describe tumor or lesion Yes
Identification Test Code assessments for identification purposes.
C154449 UHDR1TC Unified Huntington's Unified Huntington's Disease Rating Scale '99 test code. No
Disease Rating Scale '99
Test Code
C154448 UHDR1TN Unified Huntington's Unified Huntington's Disease Rating Scale '99 test name. No
Disease Rating Scale '99
Test Name
C71620 UNIT Unit Terminology codelist used for units within CDISC. Yes
C100148 UPD1TC Unified Parkinson's Unified Parkinson's Disease Rating Scale test code. No
Disease Rating Scale
page 36 of 1925
C100147 UPD1TN Unified Parkinson's Unified Parkinson's Disease Rating Scale test name. No
Disease Rating Scale
C100140 UPD2TC Movement Disorder The Movement Disorder Society version of the Unified Parkinson's No
Society Unified Disease Rating Scale test code.
Parkinson's Disease
Rating Scale
C100139 UPD2TN Movement Disorder The Movement Disorder Society version of the Unified Parkinson's No
Society Unified Disease Rating Scale test name.
Parkinson's Disease
Rating Scale
C103489 UPS01TC Urgency Perception Scale Urgency Perception Scale test code. No
C103488 UPS01TN Urgency Perception Scale Urgency Perception Scale test name. No
C129941 URNSTS Urinary System Test A terminology codelist to describe the test name for examinations of the Yes
Name urinary system.
C129942 URNSTSCD Urinary System Test A terminology codelist to describe the test code for examinations of the Yes
Code urinary system.
C141653 VALG01TC Veterans Administration Veterans Administration Lung Study Group test code. No
Lung Study Group
Test Code
C141652 VALG01TN Veterans Administration Veterans Administration Lung Study Group test name. No
Lung Study Group
Test Name
C102590 VCNEVD Vaccination Evidence Terminology relevant to the source of information regarding the Yes
Source subject's vaccination status.
C112453 VFQ1TC National Eye Institute National Eye Institute Visual Functioning Questionnaire - 25 Version No
Visual Functioning 2000 Interviewer-Administered Format test code.
Questionnaire - 25
Version 2000
Interviewer-
Administered Format
C112452 VFQ1TN National Eye Institute National Eye Institute Visual Functioning Questionnaire - 25 Version No
Visual Functioning 2000 Interviewer-Administered Format test name.
Questionnaire - 25
Version 2000
Interviewer-
Administered Format
C112455 VFQ2TC National Eye Institute National Eye Institute Visual Functioning Questionnaire - 25 Version No
Visual Functioning 2000 Self-Administered Format test code.
Questionnaire - 25
Version 2000 Self-
Administered Format
C112454 VFQ2TN National Eye Institute National Eye Institute Visual Functioning Questionnaire - 25 Version No
Visual Functioning 2000 Self-Administered Format test name.
Questionnaire - 25
Version 2000 Self-
Administered Format
C130241 VLERS1TC Vignos Lower Extremity Vignos Lower Extremity Rating Scale test code. No
C130240 VLERS1TN Vignos Lower Extremity Vignos Lower Extremity Rating Scale test name. No
C142189 VNFATS Vaccines Findings About Terminology relevant to the test names that describe findings about a Yes
Test Name vaccines event or intervention.
C142187 VNFATSCD Vaccines Findings About Terminology relevant to the test codes that describe findings about a Yes
Test Code vaccines event or intervention.
page 37 of 1925
C66770 VSRESU Units for Vital Signs The unit used to record and describe the result of a test investigating a Yes
Results vital sign. (NCI)
C67153 VSTEST Vital Signs Test Name The test name given to the test that analyzes a particular set of vital Yes
signs including temperature, respiratory rate, heart rate, and blood
pressure.
C66741 VSTESTCD Vital Signs Test Code The test code given to the test that analyzes a particular set of vital Yes
signs including temperature, respiratory rate, heart rate, and blood
pressure.
C130275 WD1TC World Health World Health Organization Disability Assessment Schedule 2.0 - 12-Item No
Organization Disability Interviewer test code.
Assessment Schedule
2.0 - 12-Item
Interviewer
C130274 WD1TN World Health World Health Organization Disability Assessment Schedule 2.0 - 12-Item No
Organization Disability Interviewer test name.
Assessment Schedule
2.0 - 12-Item
Interviewer
Organization Disability Proxy test code.
Assessment Schedule
2.0 - 12-Item Proxy
Organization Disability Proxy test name.
Assessment Schedule
2.0 - 12-Item Proxy
Organization Disability Self test code.
Assessment Schedule
2.0 - 12-Item Self
Organization Disability Self test name.
Assessment Schedule
2.0 - 12-Item Self
C130281 WD4TC World Health World Health Organization Disability Assessment Schedule 2.0 - 12 + No
Organization Disability 24-Item Interviewer test code.
Assessment Schedule
2.0 - 12 + 24-Item
Interviewer
C130280 WD4TN World Health World Health Organization Disability Assessment Schedule 2.0 - 12 + No
Organization Disability 24-Item Interviewer test name.
Assessment Schedule
2.0 - 12 + 24-Item
Interviewer
Organization Disability Interviewer test code.
Assessment Schedule
2.0 - 36-Item
Interviewer
Organization Disability Interviewer test name.
Assessment Schedule
2.0 - 36-Item
Interviewer
Organization Disability Proxy test code.
Assessment Schedule
2.0 - 36-Item Proxy
page 38 of 1925
Organization Disability Proxy test name.
Assessment Schedule
2.0 - 36-Item Proxy
Organization Disability Self test code.
Assessment Schedule
2.0 - 36-Item Self
Organization Disability Self test name.
Assessment Schedule
2.0 - 36-Item Self
C124680 WHEG01TC West Haven Hepatic West Haven Hepatic Encephalopathy Grade test code. No
Encephalopathy Grade
Test Code
C124679 WHEG01TN West Haven Hepatic West Haven Hepatic Encephalopathy Grade test name. No
Encephalopathy Grade
Test Name
C124674 WHIVS1TC WHO Clinical Staging of WHO Clinical Staging of HIV/AIDS for Adults and Adolescents test code. No
HIV/AIDS for Adults and
Adolescents Clinical
C124673 WHIVS1TN WHO Clinical Staging of WHO Clinical Staging of HIV/AIDS for Adults and Adolescents test name. No
HIV/AIDS for Adults and
C124676 WHIVS2TC WHO Clinical Staging of WHO Clinical Staging of HIV/AIDS for Children test code. No
HIV/AIDS for Children
Test Code
C124675 WHIVS2TN WHO Clinical Staging of WHO Clinical Staging of HIV/AIDS for Children test name. No
HIV/AIDS for Children
Test Name
C100176 WPAI01TC Work Productivity and Work Productivity and Activity Impairment Questionnaire - Specific No
Activity Impairment Health Problem V2.0 test code.
Questionnaire - Specific
Health Problem V2.0
C100175 WPAI01TN Work Productivity and Work Productivity and Activity Impairment Questionnaire - Specific No
Activity Impairment Health Problem V2.0 test name.
Questionnaire - Specific
Health Problem V2.0
page 39 of 1925
A4STR1TC (4 Stair Ascend Functional Test Test Code)
NCI Code: C141663, Codelist extensible: No
C141663 A4STR1TC
NCI CDISC Submission CDISC Synonym CDISC Definition NCI Preferred Term
Code Value
C141706 A4STR101 A4STR1-Time to Ascend 4 4 Stair Ascend - Time taken to ascend 4 stairs. 4 Stair Ascend - Time to
Stairs Ascend 4 Stairs
C141707 A4STR102 A4STR1-Test Grade 4 Stair Ascend - Test grade. 4 Stair Ascend - Test
Grade
C147590 A4STR103 A4STR1-Wear Orthoses 4 Stair Ascend - Did subject wear orthoses? 4 Stair Ascend - Wear
Orthoses
page 40 of 1925
A4STR1TN (4 Stair Ascend Functional Test Test Name)
C141662 A4STR1TN
Code Value
C141707 A4STR1-Test Grade A4STR1-Test Grade 4 Stair Ascend - Test grade. 4 Stair Ascend - Test
Grade
C141706 A4STR1-Time to Ascend 4 A4STR1-Time to Ascend 4 4 Stair Ascend - Time taken to ascend 4 stairs. 4 Stair Ascend - Time to
Stairs Stairs Ascend 4 Stairs
C147590 A4STR1-Wear Orthoses A4STR1-Wear Orthoses 4 Stair Ascend - Did subject wear orthoses? 4 Stair Ascend - Wear
Orthoses
page 41 of 1925
ACGC01TC (Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change Questionnaire
Test Code)
C103459 ACGC01TC
Code Value
C103531 ACGC0101 ACGC01-Clinical Alzheimer's Disease Cooperative Study-Clinical Global ADCS-CGIC - Clinical
Impression of Change Impression of Change - Clinical impression of change Impression of Change
from baseline. from Baseline
page 42 of 1925
ACGC01TN (Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change
Questionnaire Test Name)
C103458 ACGC01TN
Code Value
C103531 ACGC01-Clinical ACGC01-Clinical Alzheimer's Disease Cooperative Study-Clinical Global ADCS-CGIC - Clinical
Impression of Change Impression of Change Impression of Change - Clinical impression of change Impression of Change
from baseline. from Baseline
page 43 of 1925
ACN (Action Taken with Study Treatment)
C66767 ACN
Code Value
C49503 DOSE INCREASED An indication that a medication schedule was modified by Dose Increased
addition; either by changing the frequency, strength or
amount. (NCI)
C49504 DOSE NOT CHANGED An indication that a medication schedule was maintained. Dose Not Changed
(NCI)
C150826 DOSE RATE REDUCED An indication that the administration of a medication was Dose Rate Reduced
modified by reducing the rate at which the dose was
given, without reducing the total dose administered.
C49505 DOSE REDUCED An indication that a medication schedule was modified by Dose Reduced
subtraction, either by changing the frequency, strength or
amount. (NCI)
C49501 DRUG INTERRUPTED An indication that a medication schedule was modified by Drug Interrupted
temporarily terminating a prescribed regimen of
medication. (NCI)
C49502 DRUG WITHDRAWN An indication that a medication schedule was modified Drug Withdrawn
through termination of a prescribed regimen of
medication. (NCI)
C48660 NOT APPLICABLE NA;Not Applicable Determination of a value is not relevant in the current Not Applicable
context. (NCI)
C17998 UNKNOWN U;UNK;Unknown Not known, not observed, not recorded, or refused. (NCI) Unknown
page 44 of 1925
ACSPCAT (Acute Coronary Syndrome Presentation Category)
C101865 ACSPCAT
Code Value
C80383 NON-ST ELEVATION NON-STEMI;NSTEMI A myocardial infarction that does not produce elevation in Non-ST Elevation
MYOCARDIAL the ST segments of the ECG. Myocardial Infarction by
INFARCTION ECG Finding
C17649 OTHER Other Different than the one(s) previously specified or Other
mentioned. (NCI)
C101888 ST ELEVATION STEMI A myocardial infarction that produces elevation in the ST ST Elevation Myocardial
MYOCARDIAL segments of the ECG. Infarction by ECG Finding
INFARCTION
C66914 STABLE ANGINA Angina pectoris which has not recently changed in Stable Angina
frequency, duration or intensity. Stable angina pectoris is
relieved by rest or administration of oral, sublingual or
transdermal antianginal medications.
C66911 UNSTABLE ANGINA Angina pectoris (or equivalent type of ischemic Unstable Angina
discomfort) which has recently changed in frequency,
duration, intensity, or occurs at rest.
page 45 of 1925
ADCTC (Alzheimer's Disease Assessment Scale - Cognitive CDISC Version Questionnaire Test Code)
C100132 ADCTC
Code Value
C100209 ADCCMD Commands Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for commands. Commands Summary
Score
C100210 ADCCMD01 Commands: Fist Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for making a fist. Commands: Fist
C100211 ADCCMD02 Commands: Ceiling Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for pointing to the ceiling then Commands: Ceiling
to the floor.
C100212 ADCCMD03 Commands: Pencil Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for put the pencil on top of the Commands: Pencil
card and then put it back.
C100213 ADCCMD04 Commands: Watch Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for put the watch on the other Commands: Watch
side of the pencil and then turn over the card.
C100214 ADCCMD05 Commands: Shoulder Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for tap each shoulder twice Commands: Shoulder
with two fingers keeping your eyes shut.
C100278 ADCCMP Comprehension Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ability to comprehend speech. Comprehension
C100279 ADCCON Concentration/Distractibili Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
ty Version - Ability to concentrate or easily be distracted. Concentration/Distractibili
ty
C100226 ADCCP Constructional Praxis Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for constructional praxis. Constructional Praxis
Summary Score
C100227 ADCCP01 Constructional Praxis: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Circle Version - Constructional praxis task for copying a circle. Constructional Praxis:
Circle
C100228 ADCCP02 Constructional Praxis: 2 Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Rectangles Version - Constructional praxis task for copying two Constructional Praxis: 2
overlapping rectangles. Rectangles
Diamond Version - Constructional praxis task for copying a Constructional Praxis:
diamond. Diamond
Cube Version - Constructional praxis task for copying a cube. Constructional Praxis:
Cube
C100231 ADCCPS Attempt to Draw Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Constructional praxis attempted to draw, but Attempt to Draw
drew no forms correctly.
C100277 ADCDIF Word Finding Difficulty in Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Spont Speech Version - Difficulty finding the desired word in Difficulty in Spontaneous
spontaneous speech. Speech
C100215 ADCDRL Delayed Word Recall Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for delayed word recall. Delayed Word Recall
Summary Score
C100216 ADCDRL01 Delayed Word Recall: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Word [1] Version - Delayed word recall task for word 1. Delayed Word Recall:
Word 1
Word 2
Word 3
Word 4
page 46 of 1925
C100132 ADCTC
Code Value
Word 5
Word 6
Word 7
Word 8
Word 9
Word 10
C100232 ADCIP Ideational Praxis Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for ideational praxis. Ideational Praxis
Summary Score
C100233 ADCIP01 Ideational Praxis: Fold Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for folding the paper. Ideational Praxis: Fold
C100234 ADCIP02 Ideational Praxis: Insert Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for put the paper in the Ideational Praxis: Insert
envelop.
C100235 ADCIP03 Ideational Praxis: Seal Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for seal the envelop. Ideational Praxis: Seal
C100236 ADCIP04 Ideational Praxis: Address Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for address the envelop to Ideational Praxis: Address
yourself.
C100237 ADCIP05 Ideational Praxis: Stamp Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for showing where the Ideational Praxis: Stamp
stamp goes.
C100284 ADCMZ Executive Function Maze Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for the executive function maze Executive Function Maze
tasks. Summary Score
C100285 ADCMZ01 Executive Function Maze: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Errors Version - Number of errors during the executive function Executive Function Maze:
maze task. Errors
C100286 ADCMZ02 Executive Function Maze: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Time Version - The time in seconds stored in ISO 8601 time for Executive Function Maze:
the executive function maze task. Time
C100280 ADCNC Number Cancellation Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for the number cancellation Number Cancellation
C100281 ADCNC01 Number Cancellation: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Correct Version - Number of targets hit during the number Number Cancellation:
cancellation task. Correct
Errors Version - Number of errors during the number Number Cancellation:
cancellation task. Errors
Remind Version - Number of times reminded for the number Number Cancellation:
cancellation task. Remind
C100191 ADCOF Naming Objects and Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Fingers Version - Naming task summary score for object and Naming Objects and
fingers. Fingers Summary Score
C100204 ADCOFF01 Naming Objects and Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Fingers: Thumb Version - Naming task for fingers of the dominant hand, Naming Objects and
thumb. Fingers: Thumb
page 47 of 1925
C100132 ADCTC
Code Value
Fingers: Pointer Version - Naming task for fingers of the dominant hand, Naming Objects and
index, or pointer finger. Fingers: Pointer
Fingers: Middle Version - Naming task for fingers of the dominant hand, Naming Objects and
middle finger. Fingers: Middle
Fingers: Ring Version - Naming task for fingers of the dominant hand, Naming Objects and
ring finger. Fingers: Ring
Fingers: Pinky Version - Naming task for fingers of the dominant hand, Naming Objects and
little finger or pinky. Fingers: Pinky
C100192 ADCOFO01 Naming Objects and Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Fingers: 1 Version - Naming task for object 1. Naming Objects and
Fingers: 1
Fingers: 2
Fingers: 3
Fingers: 4
Fingers: 5
Fingers: 6
Fingers: 7
Fingers: 8
Fingers: 9
Fingers: 10
Fingers: 11
Fingers: 12
C100238 ADCOR Orientation Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for orientation. Orientation Summary
Score
C100239 ADCOR01 Orientation: Full Name Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing one's own full Orientation: Full Name
name.
C100240 ADCOR02 Orientation: Month Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current month. Orientation: Month
C100241 ADCOR03 Orientation: Date Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current day. Orientation: Date
C100242 ADCOR04 Orientation: Year Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current year. Orientation: Year
page 48 of 1925
C100132 ADCTC
Code Value
C100243 ADCOR05 Orientation: Day of Week Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current day of Orientation: Day of Week
the week.
C100244 ADCOR06 Orientation: Season Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current Orientation: Season
season.
C100245 ADCOR07 Orientation: Place Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current place. Orientation: Place
C100246 ADCOR08 Orientation: Time Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the approximate Orientation: Time
current clock time.
C100247 ADCRG Word Recognition Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Version - Summary score for word recognition across Recognition Summary
trials 1-3. Score
C100248 ADCRGT01 Word Recognition Trial 1 Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Version - Sub-score for word recognition trial 1. Recognition Trial 1
Summary Score
Summary Score
Summary Score
C100251 ADCRGW01 Word Recognition: Word Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
[1] Version - Word recognition task for word 1 Trials 1, 2, 3. Recognition: Word 1
page 49 of 1925
C100132 ADCTC
Code Value
C100275 ADCRI Remembering Test Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Instructions Version - Remembering test instructions. Remembering Test
Instructions
C100177 ADCRL Word Recall Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Version - Word recall task word average score of trials 1, Recall Average Score
2, 3.
C100178 ADCRLT01 Word Recall Trial 1 Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Version - Sub-score for word recall task trial 1. Recall Trial 1 Subscore
C100181 ADCRLW01 Word Recall: Word [1] Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Version - Word recall task word 1 for trial 1, 2, 3. Recall: Word 1
C100276 ADCSL Spoken Language Ability Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Global rating of the quality of speech, or Spoken Language Ability
difficulty in making oneself understood.
page 50 of 1925
ADCTN (Alzheimer's Disease Assessment Scale - Cognitive CDISC Version Questionnaire Test Name)
C100131 ADCTN
Code Value
C100231 Attempt to Draw Attempt to Draw Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Constructional praxis attempted to draw, but Attempt to Draw
drew no forms correctly.
C100209 Commands Commands Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for commands. Commands Summary
Score
C100211 Commands: Ceiling Commands: Ceiling Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for pointing to the ceiling then Commands: Ceiling
to the floor.
C100210 Commands: Fist Commands: Fist Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for making a fist. Commands: Fist
C100212 Commands: Pencil Commands: Pencil Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for put the pencil on top of the Commands: Pencil
card and then put it back.
C100214 Commands: Shoulder Commands: Shoulder Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for tap each shoulder twice Commands: Shoulder
with two fingers keeping your eyes shut.
C100213 Commands: Watch Commands: Watch Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Commands task for put the watch on the other Commands: Watch
side of the pencil and then turn over the card.
C100278 Comprehension Comprehension Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ability to comprehend speech. Comprehension
C100279 Concentration/Distractibili Concentration/Distractibili Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
ty ty Version - Ability to concentrate or easily be distracted. Concentration/Distractibili
ty
C100226 Constructional Praxis Constructional Praxis Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for constructional praxis. Constructional Praxis
Summary Score
C100228 Constructional Praxis: 2 Constructional Praxis: 2 Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Rectangles Rectangles Version - Constructional praxis task for copying two Constructional Praxis: 2
overlapping rectangles. Rectangles
C100227 Constructional Praxis: Constructional Praxis: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Circle Circle Version - Constructional praxis task for copying a circle. Constructional Praxis:
Circle
Cube Cube Version - Constructional praxis task for copying a cube. Constructional Praxis:
Cube
Diamond Diamond Version - Constructional praxis task for copying a Constructional Praxis:
diamond. Diamond
C100215 Delayed Word Recall Delayed Word Recall Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for delayed word recall. Delayed Word Recall
Summary Score
C100225 Delayed Word Recall: Delayed Word Recall: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Word [10] Word [10] Version - Delayed word recall task for word 10. Delayed Word Recall:
Word 10
Word 1
Word 2
Word 3
Word 4
page 51 of 1925
C100131 ADCTN
Code Value
Word 5
Word 6
Word 7
Word 8
Word 9
C100284 Executive Function Maze Executive Function Maze Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for the executive function maze Executive Function Maze
C100285 Executive Function Maze: Executive Function Maze: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Errors Errors Version - Number of errors during the executive function Executive Function Maze:
maze task. Errors
C100286 Executive Function Maze: Executive Function Maze: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Time Time Version - The time in seconds stored in ISO 8601 time for Executive Function Maze:
the executive function maze task. Time
C100232 Ideational Praxis Ideational Praxis Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for ideational praxis. Ideational Praxis
Summary Score
C100236 Ideational Praxis: Address Ideational Praxis: Address Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for address the envelop to Ideational Praxis: Address
yourself.
C100233 Ideational Praxis: Fold Ideational Praxis: Fold Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for folding the paper. Ideational Praxis: Fold
C100234 Ideational Praxis: Insert Ideational Praxis: Insert Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for put the paper in the Ideational Praxis: Insert
envelop.
C100235 Ideational Praxis: Seal Ideational Praxis: Seal Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for seal the envelop. Ideational Praxis: Seal
C100237 Ideational Praxis: Stamp Ideational Praxis: Stamp Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Ideational praxis task for showing where the Ideational Praxis: Stamp
stamp goes.
C100191 Naming Objects and Naming Objects and Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Fingers Fingers Version - Naming task summary score for object and Naming Objects and
fingers. Fingers Summary Score
Fingers: 1 Fingers: 1 Version - Naming task for object 1. Naming Objects and
Fingers: 1
Fingers: 10
Fingers: 11
Fingers: 12
Fingers: 2
Fingers: 3
page 52 of 1925
C100131 ADCTN
Code Value
Fingers: 4
Fingers: 5
Fingers: 6
Fingers: 7
Fingers: 8
Fingers: 9
Fingers: Middle Fingers: Middle Version - Naming task for fingers of the dominant hand, Naming Objects and
middle finger. Fingers: Middle
Fingers: Pinky Fingers: Pinky Version - Naming task for fingers of the dominant hand, Naming Objects and
little finger or pinky. Fingers: Pinky
Fingers: Pointer Fingers: Pointer Version - Naming task for fingers of the dominant hand, Naming Objects and
index, or pointer finger. Fingers: Pointer
Fingers: Ring Fingers: Ring Version - Naming task for fingers of the dominant hand, Naming Objects and
ring finger. Fingers: Ring
Fingers: Thumb Fingers: Thumb Version - Naming task for fingers of the dominant hand, Naming Objects and
thumb. Fingers: Thumb
C100280 Number Cancellation Number Cancellation Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for the number cancellation Number Cancellation
C100281 Number Cancellation: Number Cancellation: Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Correct Correct Version - Number of targets hit during the number Number Cancellation:
cancellation task. Correct
Errors Errors Version - Number of errors during the number Number Cancellation:
cancellation task. Errors
Remind Remind Version - Number of times reminded for the number Number Cancellation:
cancellation task. Remind
C100238 Orientation Orientation Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Summary score for orientation. Orientation Summary
Score
C100241 Orientation: Date Orientation: Date Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current day. Orientation: Date
C100243 Orientation: Day of Week Orientation: Day of Week Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current day of Orientation: Day of Week
the week.
C100239 Orientation: Full Name Orientation: Full Name Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing one's own full Orientation: Full Name
name.
C100240 Orientation: Month Orientation: Month Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current month. Orientation: Month
C100245 Orientation: Place Orientation: Place Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current place. Orientation: Place
page 53 of 1925
C100131 ADCTN
Code Value
C100244 Orientation: Season Orientation: Season Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current Orientation: Season
season.
C100246 Orientation: Time Orientation: Time Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the approximate Orientation: Time
current clock time.
C100242 Orientation: Year Orientation: Year Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Orientation task for knowing the current year. Orientation: Year
C100275 Remembering Test Remembering Test Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Instructions Instructions Version - Remembering test instructions. Remembering Test
Instructions
C100276 Spoken Language Ability Spoken Language Ability Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog -
Version - Global rating of the quality of speech, or Spoken Language Ability
difficulty in making oneself understood.
C100277 Word Finding Difficulty in Word Finding Difficulty in Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Spont Speech Spont Speech Version - Difficulty finding the desired word in Difficulty in Spontaneous
spontaneous speech. Speech
C100177 Word Recall Word Recall Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Version - Word recall task word average score of trials 1, Recall Average Score
2, 3.
C100178 Word Recall Trial 1 Word Recall Trial 1 Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
C100190 Word Recall: Word [10] Word Recall: Word [10] Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
C100247 Word Recognition Word Recognition Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Version - Summary score for word recognition across Recognition Summary
trials 1-3. Score
C100248 Word Recognition Trial 1 Word Recognition Trial 1 Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
Summary Score
Summary Score
Summary Score
page 54 of 1925
C100131 ADCTN
Code Value
C100260 Word Recognition: Word Word Recognition: Word Alzheimer's Disease Assessment Scale-Cognitive CDISC CDISC ADAS-Cog - Word
[10] [10] Version - Word recognition task for word 10 Trials 1, 2, 3. Recognition: Word 10
page 55 of 1925
ADL01TC (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory Questionnaire
Test Code)
C105140 ADL01TC
Code Value
C105283 ADL0101 ADL01-Usual Eating Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Living Inventory - Regarding eating: which best describes of Usual Performance of
{S} usual performance during the past 4 weeks? Eating
C105284 ADL0102 ADL01-Optimal Walking Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Living Inventory - Regarding walking (or getting around of Optimal Performance
in a wheelchair), in the past 4 weeks, which best of Walking
describes his/her optimal performance.
C105285 ADL0103 ADL01-Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Usual Bowel
Bowel/Bladder Function Living Inventory - Regarding bowel and bladder function and Bladder Function at
at the toilet, which best describes his/her usual Toilet
performance in the past 4 weeks.
C105286 ADL0104 ADL01-Usual Bathing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Living Inventory - Regarding bathing, in the past 4 of Usual Performance of
weeks, which best describes his/her usual performance. Bathing
C105287 ADL0105 ADL01-Optimal Grooming Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Living Inventory - Regarding grooming, in the past 4 of Optimal Performance
weeks, which best describes his/her optimal performance. of Grooming
C105288 ADL0106 ADL01-Select First Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Select First
Clothes for the Day Living Inventory - Regarding dressing in the past 4 Clothes for the Day
weeks: Did {S} select his/her first set of clothes for the
day?
C105289 ADL0106A ADL01-Usual Dressing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Living Inventory - If yes, which best describes usual of Usual Performance of
performance. Dressing
C105290 ADL0106B ADL01-Usual Physically Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Dressing Perform Living Inventory - Regarding physically getting dressed, of Usual Performance of
which best describes his/her usual performance in the Physically Getting
past 4 weeks. Dressed
C105291 ADL0107 ADL01-Use a Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Use a
Living Inventory - In the past 4 weeks, did {S} use a Telephone
telephone?
C105292 ADL0107A ADL01-Highest Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Use Performance Living Inventory - If yes, which best describes his/her of Highest Performance of
highest level of performance. Telephone Use
C105293 ADL0108 ADL01-Watch Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Watch
Living Inventory - In the past 4 weeks, did {S} watch Television
television?
C105294 ADL0108A ADL01-Select Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Select or Ask
Program Living Inventory - Did {S} usually select or ask for for Television Program
different programs or his/her favorite show?
C105295 ADL0108B ADL01-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Content While Watch Living Inventory - Did {S} usually talk about the content TV Content While
of a program while watching it? Watching
C105296 ADL0108C ADL01-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Content Within a Day Living Inventory - Did {S} talk about the content of a TV Content Within a Day
program within a day (24 hours) after watching it? After Watching
C105297 ADL0109 ADL01-Pay Attention to Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pay
Conversation Living Inventory - In the past 4 weeks, did {S} ever Attention to Conversation
appear to pay attention to conversation or small talk for
at least 5 minutes?
C105298 ADL0109A ADL01-Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Usual
Conversation Participation Living Inventory - If yes, which best describes his/her Conversation Participation
usual degree of participation.
C105299 ADL0110 ADL01-Clear Dishes Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Clear Dishes
Living Inventory - Did {S} clear the dishes from the table After Meal or Snack
after a meal or snack?
C105300 ADL0110A ADL01-Clear Dishes Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Living Inventory - If yes, which best describes how of Usual Performance of
he/she usually performed. Clearing Dishes
page 56 of 1925
C105140 ADL01TC
Code Value
C105301 ADL0111 ADL01-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Find Personal
Living Inventory - In the past 4 weeks, did {S} usually Belongings at Home
manage to find his/her personal belongings at home?
C105302 ADL0111A ADL01-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Usual Performance Living Inventory - If yes, which best describes how of Usual Performance of
he/she usually performed. Finding Personal
Belonging at Home
C105303 ADL0112 ADL01-Obtain Beverage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Obtain
Living Inventory - In the past 4 weeks, did {S} obtain a Beverage for Self
hot or cold beverage for him/herself?
C105304 ADL0112A ADL01-Obtain Beverage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Highest Perform Living Inventory - If yes, which best describes his/her of Highest Performance of
highest level of performance. Obtaining Beverage
C105305 ADL0113 ADL01-Make a Meal Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Make a Meal
Living Inventory - In the past 4 weeks, did {S} make or Snack at Home
him/herself a meal or snack at home?
C105306 ADL0113A ADL01-Highest Level of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Highest
Food Preparation Living Inventory - If yes, which best describes his/her Level of Food Preparation
highest level of food preparation.
C105307 ADL0114 ADL01-Dispose of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Dispose of
Garbage Living Inventory - In the past 4 weeks, did {S} dispose of Garbage in Appropriate
garbage or litter in an appropriate place or container at Place at Home
home?
C105308 ADL0114A ADL01-Dispose Garbage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Usual Performance Living Inventory - If yes, which best describes how of Usual Performance of
he/she usually performed. Garbage Disposal
C105309 ADL0115 ADL01-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Get Around
Outside Home Living Inventory - In the past 4 weeks, did {S} get Outside Home
around (or travel) outside of his/her home?
C105310 ADL0115A ADL01-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Optimal Performance Living Inventory - If yes, which best describes his/her of Optimal Performance
optimal performance. of Getting Around Outside
of Home
C105311 ADL0116 ADL01-Go Shopping Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Go Shopping
Living Inventory - In the past 4 weeks, did {S} ever go
shopping?
C105312 ADL0116A ADL01-How Usually Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - How Subject
Selects Items Living Inventory - Which one best describes how {S} Usually Selects Items
usually selects items.
C105313 ADL0116B ADL01-Pay Without Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pay for
Supervision Living Inventory - Did {S} usually pay for items without Items Without
supervision or physical help? Supervision or Physical
Help
C105314 ADL0117 ADL01-Keep Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Keep
Appointments Living Inventory - In the past 4 weeks, did {S} keep Appointments or Meetings
appointments or meetings with other people, such as with Others
relatives, a doctor, the hairdresser, etc.?
C105315 ADL0117A ADL01-Aware of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Appointment Ahead of Living Inventory - If yes, which best describes his/her of Awareness of
Time awareness of the meeting ahead of time. Appointment Ahead of
Time
C105316 ADL0118 ADL01-Left On His/Her Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Subject Left
Own Living Inventory - In the past 4 weeks, was {S} ever left on Their Own
on his/her own?
C105317 ADL0118A ADL01-Left Away From Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Left Away
Home Living Inventory - Was {S} left away from home, for 15 From Home for Fifteen
minutes or longer, during the day? Minutes or Longer
C105318 ADL0118B ADL01-Left at Home for 1 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Left at Home
Hour or Longer Living Inventory - Was {S} left: at home, for an hour or for One Hour or Longer
longer, during the day?
C105319 ADL0118C ADL01-Left at Home for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Left at Home
Less Than 1 Hour Living Inventory - Was {S} left at home, for less than 1 for Less Than One Hour
hour, during the day?
page 57 of 1925
C105140 ADL01TC
Code Value
C105320 ADL0119 ADL01-Talk About Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Current Events Living Inventory - In the past 4 weeks, did {S} talk about Current Events
current events?
C105321 ADL0119A ADL01-Talk About Events Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Heard/Read About Living Inventory - Did {S} talk about events that he/she Events on TV that Subject
heard or read about or saw on TV but did not take part Did not Take Part In
in?
C105322 ADL0119B ADL01-Talk About Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Outside Events Living Inventory - Did {S} talk about events that he/she Events Outside of Home
took part in outside home involving family, friends, or that Subject Took Part In
neighbors?
C105323 ADL0119C ADL01-Talk About at Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Home Events Living Inventory - Did {S} talk about events that Events at Home that
occurred at home that he/she took part in or watched? Subject Took Part in or
Watched
C105324 ADL0120 ADL01-Read More Than 5 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Read for
Minutes Living Inventory - In the past 4 weeks, did {S} read a More Than Five Minutes
magazine, newspaper or book for more than 5 minutes at
a time?
C105325 ADL0120A ADL01-Talk Within 1 Hour Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
After Reading Living Inventory - Did {S} usually talk about details of What Subject Read Less
what he/she read while or shortly (less than 1 hour) after Than One Hour After
reading? Reading
C105326 ADL0120B ADL01-Talk 1 Hour or Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
More After Reading Living Inventory - Did {S} usually talk about what he/she What Subject Read More
read 1 hour or longer after reading? Than One Hour After
Reading
C105327 ADL0121 ADL01-Write Things Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Write Things
Down Living Inventory - In the past 4 weeks, did {S} ever write Down
things down?
C105328 ADL0121A ADL01-Most Complicated Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Writings Living Inventory - If yes, which best describes the most of Most Complicated
complicated things that he/she wrote. Writings
C105329 ADL0122 ADL01-Perform Pastime Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Perform
Living Inventory - In the past 4 weeks, did {S} perform a Pastime, Hobby or Game
pastime, hobby or game?
C105330 ADL0122A ADL01-Pastime: Card or Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Board Games Living Inventory - Which pastimes did he/she perform: Card or Board Games
Card or board games.
C105331 ADL0122B ADL01-Pastime: Bingo Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Bingo
bingo.
C105332 ADL0122C ADL01-Pastime: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Crosswords Living Inventory - Which pastimes did he/she perform: Crosswords
crosswords.
C105333 ADL0122D ADL01-Pastime: Art Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime: Art
Living Inventory - Which pastimes did he/she perform:
art.
C105334 ADL0122E ADL01-Pastime: Musical Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Instrument Living Inventory - Which pastimes did he/she perform: Musical Instrument
musical instrument.
C105335 ADL0122F ADL01-Pastime: Knitting Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Knitting
knitting.
C105336 ADL0122G ADL01-Pastime: Sewing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Sewing
sewing.
C105337 ADL0122H ADL01-Pastime: Reading Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Reading
reading.
C105338 ADL0122I ADL01-Pastime: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Gardening Living Inventory - Which pastimes did he/she perform: Gardening
gardening.
page 58 of 1925
C105140 ADL01TC
Code Value
C105339 ADL0122J ADL01-Pastime: Golf Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Golf
golf.
C105340 ADL0122K ADL01-Pastime: Tennis Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Tennis
tennis.
C105341 ADL0122L ADL01-Pastime: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Workshop Living Inventory - Which pastimes did he/she perform: Workshop
workshop.
C105342 ADL0122M ADL01-Pastime: Fishing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Fishing
fishing.
C105343 ADL0122N ADL01-Pastime: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Other
other.
C105344 ADL0122O ADL01-Pastime: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Specify Living Inventory - Which pastimes did he/she perform: Other Specify
other specify.
C105345 ADL0122P ADL01-Hobbies Only at Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Performed
Day Care Living Inventory - If {S} performs hobbies/pastimes only Hobbies Only at Day Care
at day care, check here.
C105346 ADL0122Q ADL01-Usual Common Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Pastimes Performance Living Inventory - If yes, how did {S} usually perform of Usual Performance of
his/her most common pastimes. Common Pastimes
C105347 ADL0123 ADL01-Use Household Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Use
Appliance Living Inventory - In the past 4 weeks, did {S} use a Household Appliance to
household appliance to do chores? do Chores
C105348 ADL0123A ADL01-Appliance: Washer Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: washer. Washer
C105349 ADL0123B ADL01-Appliance: Dryer Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: dryer. Dryer
C105350 ADL0123C ADL01-Appliance: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Vacuum Living Inventory - Check all that were used: vacuum. Vacuum
C105351 ADL0123D ADL01-Appliance: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Dishwasher Living Inventory - Check all that were used: dishwasher. Dishwasher
C105352 ADL0123E ADL01-Appliance: Toaster Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: toaster. Toaster
C105353 ADL0123F ADL01-Appliance: Toaster Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Oven Living Inventory - Check all that were used: toaster oven. Toaster Oven
C105354 ADL0123G ADL01-Appliance: Range Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: range. Range
C105355 ADL0123H ADL01-Appliance: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Microwave Living Inventory - Check all that were used: microwave. Microwave
C105356 ADL0123I ADL01-Appliance: Food Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Processor Living Inventory - Check all that were used: food Food Processor
processor.
C105357 ADL0123J ADL01-Appliance: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: other. Other
C105358 ADL0123K ADL01-Appliance: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Specify Living Inventory - Check all that were used: other Other Specify
specify.
C105359 ADL0123L ADL01-Use Common Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Used Appliances Living Inventory - If yes, for the most commonly used of Usual Use of
appliances, which best describes how {S} usually used Commonly Used
them. Appliances
C105360 ADL0124 ADL01-Total ADCS-ADL Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Total Score
Score Living Inventory - Total Score.
C105361 ADL0125 ADL01-Number Don't Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Number of
Know Responses Living Inventory - Number of 'Don't Know' Responses. 'Don't Know' Responses
page 59 of 1925
ADL01TN (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory Questionnaire
Test Name)
C105139 ADL01TN
Code Value
C105351 ADL01-Appliance: ADL01-Appliance: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Dishwasher Dishwasher Living Inventory - Check all that were used: dishwasher. Dishwasher
C105349 ADL01-Appliance: Dryer ADL01-Appliance: Dryer Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: dryer. Dryer
C105356 ADL01-Appliance: Food ADL01-Appliance: Food Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Processor Processor Living Inventory - Check all that were used: food Food Processor
processor.
Microwave Microwave Living Inventory - Check all that were used: microwave. Microwave
C105357 ADL01-Appliance: Other ADL01-Appliance: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: other. Other
C105358 ADL01-Appliance: Other ADL01-Appliance: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Specify Specify Living Inventory - Check all that were used: other Other Specify
specify.
C105354 ADL01-Appliance: Range ADL01-Appliance: Range Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: range. Range
C105352 ADL01-Appliance: Toaster ADL01-Appliance: Toaster Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: toaster. Toaster
C105353 ADL01-Appliance: Toaster ADL01-Appliance: Toaster Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Oven Oven Living Inventory - Check all that were used: toaster oven. Toaster Oven
Vacuum Vacuum Living Inventory - Check all that were used: vacuum. Vacuum
C105348 ADL01-Appliance: Washer ADL01-Appliance: Washer Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Appliance:
Living Inventory - Check all that were used: washer. Washer
C105315 ADL01-Aware of ADL01-Aware of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Appointment Ahead of Appointment Ahead of Living Inventory - If yes, which best describes his/her of Awareness of
Time Time awareness of the meeting ahead of time. Appointment Ahead of
Time
C105299 ADL01-Clear Dishes ADL01-Clear Dishes Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Clear Dishes
Living Inventory - Did {S} clear the dishes from the table After Meal or Snack
after a meal or snack?
C105300 ADL01-Clear Dishes Usual ADL01-Clear Dishes Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Performance Living Inventory - If yes, which best describes how of Usual Performance of
he/she usually performed. Clearing Dishes
C105308 ADL01-Dispose Garbage ADL01-Dispose Garbage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Usual Performance Usual Performance Living Inventory - If yes, which best describes how of Usual Performance of
he/she usually performed. Garbage Disposal
C105307 ADL01-Dispose of ADL01-Dispose of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Dispose of
Garbage Garbage Living Inventory - In the past 4 weeks, did {S} dispose of Garbage in Appropriate
garbage or litter in an appropriate place or container at Place at Home
home?
C105301 ADL01-Find Belongings ADL01-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Find Personal
Living Inventory - In the past 4 weeks, did {S} usually Belongings at Home
manage to find his/her personal belongings at home?
C105302 ADL01-Find Belongings ADL01-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Usual Performance Usual Performance Living Inventory - If yes, which best describes how of Usual Performance of
he/she usually performed. Finding Personal
Belonging at Home
C105310 ADL01-Get Around ADL01-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Optimal Performance Optimal Performance Living Inventory - If yes, which best describes his/her of Optimal Performance
optimal performance. of Getting Around Outside
of Home
C105309 ADL01-Get Around ADL01-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Get Around
Outside Home Outside Home Living Inventory - In the past 4 weeks, did {S} get Outside Home
around (or travel) outside of his/her home?
C105311 ADL01-Go Shopping ADL01-Go Shopping Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Go Shopping
Living Inventory - In the past 4 weeks, did {S} ever go
shopping?
page 60 of 1925
C105139 ADL01TN
Code Value
C105306 ADL01-Highest Level of ADL01-Highest Level of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Highest
Food Preparation Food Preparation Living Inventory - If yes, which best describes his/her Level of Food Preparation
highest level of food preparation.
C105292 ADL01-Highest Telephone ADL01-Highest Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Use Performance Use Performance Living Inventory - If yes, which best describes his/her of Highest Performance of
highest level of performance. Telephone Use
C105345 ADL01-Hobbies Only at ADL01-Hobbies Only at Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Performed
Day Care Day Care Living Inventory - If {S} performs hobbies/pastimes only Hobbies Only at Day Care
at day care, check here.
C105312 ADL01-How Usually ADL01-How Usually Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - How Subject
Selects Items Selects Items Living Inventory - Which one best describes how {S} Usually Selects Items
usually selects items.
C105314 ADL01-Keep ADL01-Keep Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Keep
Appointments Appointments Living Inventory - In the past 4 weeks, did {S} keep Appointments or Meetings
appointments or meetings with other people, such as with Others
relatives, a doctor, the hairdresser, etc.?
C105318 ADL01-Left at Home for 1 ADL01-Left at Home for 1 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Left at Home
Hour or Longer Hour or Longer Living Inventory - Was {S} left: at home, for an hour or for One Hour or Longer
longer, during the day?
C105319 ADL01-Left at Home for ADL01-Left at Home for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Left at Home
Less Than 1 Hour Less Than 1 Hour Living Inventory - Was {S} left at home, for less than 1 for Less Than One Hour
hour, during the day?
C105317 ADL01-Left Away From ADL01-Left Away From Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Left Away
Home Home Living Inventory - Was {S} left away from home, for 15 From Home for Fifteen
minutes or longer, during the day? Minutes or Longer
C105316 ADL01-Left On His/Her ADL01-Left On His/Her Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Subject Left
Own Own Living Inventory - In the past 4 weeks, was {S} ever left on Their Own
on his/her own?
C105305 ADL01-Make a Meal ADL01-Make a Meal Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Make a Meal
Living Inventory - In the past 4 weeks, did {S} make or Snack at Home
him/herself a meal or snack at home?
C105328 ADL01-Most Complicated ADL01-Most Complicated Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Writings Writings Living Inventory - If yes, which best describes the most of Most Complicated
complicated things that he/she wrote. Writings
C105361 ADL01-Number Don't ADL01-Number Don't Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Number of
Know Responses Know Responses Living Inventory - Number of 'Don't Know' Responses. 'Don't Know' Responses
C105303 ADL01-Obtain Beverage ADL01-Obtain Beverage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Obtain
Living Inventory - In the past 4 weeks, did {S} obtain a Beverage for Self
hot or cold beverage for him/herself?
C105304 ADL01-Obtain Beverage ADL01-Obtain Beverage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Highest Perform Highest Perform Living Inventory - If yes, which best describes his/her of Highest Performance of
highest level of performance. Obtaining Beverage
C105287 ADL01-Optimal Grooming ADL01-Optimal Grooming Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Performance Living Inventory - Regarding grooming, in the past 4 of Optimal Performance
weeks, which best describes his/her optimal performance. of Grooming
C105284 ADL01-Optimal Walking ADL01-Optimal Walking Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Performance Living Inventory - Regarding walking (or getting around of Optimal Performance
in a wheelchair), in the past 4 weeks, which best of Walking
describes his/her optimal performance.
C105333 ADL01-Pastime: Art ADL01-Pastime: Art Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime: Art
Living Inventory - Which pastimes did he/she perform:
art.
C105331 ADL01-Pastime: Bingo ADL01-Pastime: Bingo Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Bingo
bingo.
C105330 ADL01-Pastime: Card or ADL01-Pastime: Card or Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Board Games Board Games Living Inventory - Which pastimes did he/she perform: Card or Board Games
Card or board games.
C105332 ADL01-Pastime: ADL01-Pastime: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Crosswords Crosswords Living Inventory - Which pastimes did he/she perform: Crosswords
crosswords.
C105342 ADL01-Pastime: Fishing ADL01-Pastime: Fishing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Fishing
fishing.
page 61 of 1925
C105139 ADL01TN
Code Value
Gardening Gardening Living Inventory - Which pastimes did he/she perform: Gardening
gardening.
C105339 ADL01-Pastime: Golf ADL01-Pastime: Golf Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Golf
golf.
C105335 ADL01-Pastime: Knitting ADL01-Pastime: Knitting Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Knitting
knitting.
C105334 ADL01-Pastime: Musical ADL01-Pastime: Musical Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Instrument Instrument Living Inventory - Which pastimes did he/she perform: Musical Instrument
musical instrument.
C105343 ADL01-Pastime: Other ADL01-Pastime: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Other
other.
C105344 ADL01-Pastime: Other ADL01-Pastime: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Specify Specify Living Inventory - Which pastimes did he/she perform: Other Specify
other specify.
C105337 ADL01-Pastime: Reading ADL01-Pastime: Reading Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Reading
reading.
C105336 ADL01-Pastime: Sewing ADL01-Pastime: Sewing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Sewing
sewing.
C105340 ADL01-Pastime: Tennis ADL01-Pastime: Tennis Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pastime:
Living Inventory - Which pastimes did he/she perform: Tennis
tennis.
Workshop Workshop Living Inventory - Which pastimes did he/she perform: Workshop
workshop.
C105297 ADL01-Pay Attention to ADL01-Pay Attention to Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pay
Conversation Conversation Living Inventory - In the past 4 weeks, did {S} ever Attention to Conversation
appear to pay attention to conversation or small talk for
at least 5 minutes?
C105313 ADL01-Pay Without ADL01-Pay Without Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Pay for
Supervision Supervision Living Inventory - Did {S} usually pay for items without Items Without
supervision or physical help? Supervision or Physical
Help
C105329 ADL01-Perform Pastime ADL01-Perform Pastime Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Perform
Living Inventory - In the past 4 weeks, did {S} perform a Pastime, Hobby or Game
pastime, hobby or game?
C105324 ADL01-Read More Than 5 ADL01-Read More Than 5 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Read for
Minutes Minutes Living Inventory - In the past 4 weeks, did {S} read a More Than Five Minutes
magazine, newspaper or book for more than 5 minutes at
a time?
C105288 ADL01-Select First ADL01-Select First Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Select First
Clothes for the Day Clothes for the Day Living Inventory - Regarding dressing in the past 4 Clothes for the Day
weeks: Did {S} select his/her first set of clothes for the
day?
C105294 ADL01-Select Television ADL01-Select Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Select or Ask
Program Program Living Inventory - Did {S} usually select or ask for for Television Program
different programs or his/her favorite show?
C105326 ADL01-Talk 1 Hour or ADL01-Talk 1 Hour or Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
More After Reading More After Reading Living Inventory - Did {S} usually talk about what he/she What Subject Read More
read 1 hour or longer after reading? Than One Hour After
Reading
C105323 ADL01-Talk About at ADL01-Talk About at Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Home Events Home Events Living Inventory - Did {S} talk about events that Events at Home that
occurred at home that he/she took part in or watched? Subject Took Part in or
Watched
C105320 ADL01-Talk About ADL01-Talk About Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Current Events Current Events Living Inventory - In the past 4 weeks, did {S} talk about Current Events
current events?
page 62 of 1925
C105139 ADL01TN
Code Value
C105321 ADL01-Talk About Events ADL01-Talk About Events Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Heard/Read About Heard/Read About Living Inventory - Did {S} talk about events that he/she Events on TV that Subject
heard or read about or saw on TV but did not take part Did not Take Part In
in?
C105322 ADL01-Talk About ADL01-Talk About Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Outside Events Outside Events Living Inventory - Did {S} talk about events that he/she Events Outside of Home
took part in outside home involving family, friends, or that Subject Took Part In
neighbors?
C105295 ADL01-Talk About TV ADL01-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Content While Watch Content While Watch Living Inventory - Did {S} usually talk about the content TV Content While
of a program while watching it? Watching
C105296 ADL01-Talk About TV ADL01-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
Content Within a Day Content Within a Day Living Inventory - Did {S} talk about the content of a TV Content Within a Day
program within a day (24 hours) after watching it? After Watching
C105325 ADL01-Talk Within 1 Hour ADL01-Talk Within 1 Hour Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Talk About
After Reading After Reading Living Inventory - Did {S} usually talk about details of What Subject Read Less
what he/she read while or shortly (less than 1 hour) after Than One Hour After
reading? Reading
C105360 ADL01-Total ADCS-ADL ADL01-Total ADCS-ADL Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Total Score
Score Score Living Inventory - Total Score.
C105291 ADL01-Use a Telephone ADL01-Use a Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Use a
Living Inventory - In the past 4 weeks, did {S} use a Telephone
telephone?
C105359 ADL01-Use Common ADL01-Use Common Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Used Appliances Used Appliances Living Inventory - If yes, for the most commonly used of Usual Use of
appliances, which best describes how {S} usually used Commonly Used
them. Appliances
C105347 ADL01-Use Household ADL01-Use Household Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Use
Appliance Appliance Living Inventory - In the past 4 weeks, did {S} use a Household Appliance to
household appliance to do chores? do Chores
C105286 ADL01-Usual Bathing ADL01-Usual Bathing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Performance Living Inventory - Regarding bathing, in the past 4 of Usual Performance of
weeks, which best describes his/her usual performance. Bathing
C105285 ADL01-Usual ADL01-Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Usual Bowel
Bowel/Bladder Function Bowel/Bladder Function Living Inventory - Regarding bowel and bladder function and Bladder Function at
at the toilet, which best describes his/her usual Toilet
performance in the past 4 weeks.
C105346 ADL01-Usual Common ADL01-Usual Common Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Pastimes Performance Pastimes Performance Living Inventory - If yes, how did {S} usually perform of Usual Performance of
his/her most common pastimes. Common Pastimes
C105298 ADL01-Usual ADL01-Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Usual
Conversation Participation Conversation Participation Living Inventory - If yes, which best describes his/her Conversation Participation
usual degree of participation.
C105289 ADL01-Usual Dressing ADL01-Usual Dressing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Performance Living Inventory - If yes, which best describes usual of Usual Performance of
performance. Dressing
C105283 ADL01-Usual Eating ADL01-Usual Eating Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Performance Performance Living Inventory - Regarding eating: which best describes of Usual Performance of
{S} usual performance during the past 4 weeks? Eating
C105290 ADL01-Usual Physically ADL01-Usual Physically Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Description
Dressing Perform Dressing Perform Living Inventory - Regarding physically getting dressed, of Usual Performance of
which best describes his/her usual performance in the Physically Getting
past 4 weeks. Dressed
C105293 ADL01-Watch Television ADL01-Watch Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Watch
Living Inventory - In the past 4 weeks, did {S} watch Television
television?
C105327 ADL01-Write Things ADL01-Write Things Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL - Write Things
Down Down Living Inventory - In the past 4 weeks, did {S} ever write Down
things down?
page 63 of 1925
ADL02TC (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory Severe Dementia
Version Questionnaire Test Code)
C106653 ADL02TC
Code Value
C106979 ADL0201 ADL02-Usual Eating Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Performance Living Inventory, Severe Dementia Version - Regarding Dementia - Description of
eating, which best describes {S} usual performance Usual Performance of
during the last 4 weeks? Eating
C106980 ADL0202 ADL02-Optimal Walking Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
walking (or getting around in a wheelchair) in the past 4 Optimal Performance of
weeks, which best describes {S} optimal performance? Walking
C106981 ADL0203 ADL02-Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Bowel/Bladder Function Living Inventory, Severe Dementia Version - Regarding Dementia - Usual Bowel
bowel and bladder function at the toilet, which best and Bladder Function at
describes {S} usual performance during the past 4 Toilet
weeks?
C106982 ADL0204 ADL02-Usual Bathing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
bathing, in the past 4 weeks, which best describes {S} Usual Performance of
usual performance? Bathing
C106983 ADL0205 ADL02-Optimal Grooming Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
grooming, in the past 4 weeks, which best describes {S} Optimal Performance of
optimal performance? Grooming
C106984 ADL0206 ADL02-Usual Physically Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Dressing Perform Living Inventory, Severe Dementia Version - Regarding Dementia - Description of
physically getting dressed, which best describes {S} Usual Performance of
usual performance in the past 4 weeks? Physically Getting
Dressed
C106985 ADL0207 ADL02-Use a Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Use a
weeks, did {S} use a telephone? Telephone
C106986 ADL0207A ADL02-Highest Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Use Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
best describes {S} highest level of performance. Highest Performance of
Telephone Use
C106987 ADL0208 ADL02-Watch Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Watch
weeks, did {S} watch television? Television
C106988 ADL0208A ADL02-Select Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Program Living Inventory, Severe Dementia Version - Did {S} Dementia - Select or Ask
usually select or ask for different programs or {S} for Television Program
favorite show?
C106989 ADL0208B ADL02-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Content While Watch Living Inventory, Severe Dementia Version - Did {S} Dementia - Talk About TV
usually talk about the content of a program while Content While Watching
watching it?
C106990 ADL0208C ADL02-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Content Within a Day Living Inventory, Severe Dementia Version - Did {S} talk Dementia - Talk About TV
about the content of a program within a day (24 hours) Content Within a Day
after watching it? After Watching
C106991 ADL0209 ADL02-Pay Attention to Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Conversation Living Inventory, Severe Dementia Version - In the past 4 Dementia - Pay Attention
weeks, did {S} ever appear to pay attention to to Conversation
conversation or small talk for at least 5 minutes?
C106992 ADL0209A ADL02-Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Conversation Participation Living Inventory, Severe Dementia Version - If yes, which Dementia - Usual
best describes {S} usual degree of participation. Conversation Participation
C106993 ADL0210 ADL02-Clear Dishes Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - Did {S} Dementia - Clear Dishes
clear the dishes from the table after a meal or snack? After Meal or Snack
C106994 ADL0210A ADL02-Clear Dishes Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
best describes how {S} usually performed. Usual Performance of
Clearing Dishes
page 64 of 1925
C106653 ADL02TC
Code Value
C106995 ADL0211 ADL02-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Find Personal
weeks, did {S} usually manage to find his/her personal Belongings at Home
belongings at home?
C106996 ADL0211A ADL02-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Usual Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
Finding Personal
Belonging at Home
C106997 ADL0212 ADL02-Obtain Beverage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Obtain
weeks, did {S} obtain a hot or cold beverage for Beverage for Self
him/herself?
C106998 ADL0212A ADL02-Obtain Beverage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Highest Perform Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
Obtaining Beverage
C106999 ADL0213 ADL02-Dispose of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Garbage Living Inventory, Severe Dementia Version - In the past 4 Dementia - Dispose of
weeks, did {S} dispose of garbage or litter in an Garbage in Appropriate
appropriate place or container at home? Place at Home
C107000 ADL0213A ADL02-Dispose Garbage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Usual Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
Garbage Disposal
C107001 ADL0214 ADL02-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Outside Home Living Inventory, Severe Dementia Version - In the past 4 Dementia - Get Around
weeks, did {S} get around (or travel) outside of his/her Outside Home
home?
C107002 ADL0214A ADL02-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Optimal Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
best describes {S} optimal performance. Optimal Performance of
Getting Around Outside of
Home
C107003 ADL0215 ADL02-Left On His/Her Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Own Living Inventory, Severe Dementia Version - In the past 4 Dementia - Subject Left
weeks, was {S} ever left on his/her own? on Their Own
C107004 ADL0215A ADL02-Left Away From Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Home Living Inventory, Severe Dementia Version - Was {S} Dementia - Alone Away
left: away from home for 15 minutes or longer, during From Home for Fifteen
the day? Minutes or Longer
C107005 ADL0215B ADL02-Left at Home for 1 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Hour or Longer Living Inventory, Severe Dementia Version - Was {S} Dementia - Alone at
left: at home for an hour or longer during the day? Home for One Hour or
Longer
C107006 ADL0215C ADL02-Left at Home for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Less Than 1 Hour Living Inventory, Severe Dementia Version - Was {S} Dementia - Alone at
left: at home for less than 1 hour during the day? Home for Less Than One
Hour
C107007 ADL0216 ADL02-Run Water Faucet Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
to Wash Living Inventory, Severe Dementia Version - In the past 4 Dementia - Turn On
weeks, did {S} usually run water from a faucet to wash Faucet to Wash Without
{S} hands or face without help? Help
C107008 ADL0217 ADL02-Turn Off Faucet Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Turn Off
weeks, did {S} usually turn off the faucet after finishing Faucet After Wash
running water without help? Without Help
C107009 ADL0218 ADL02-Turn On Light Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Turn On Light
weeks, did {S} usually turn on a light without help when Without Help Entering
entering a dark room or area? Room
C107010 ADL0219 ADL02-Turn Off Light Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Turn Off Light
weeks, did {S} usually turn off lights without help when Without Help Leaving
leaving a room or going to sleep? Room
C107011 ADL0220 ADL02-Sum 1 to 5 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - Sum of Dementia - Sum of Items
Items 1-5. 1-5
page 65 of 1925
C106653 ADL02TC
Code Value
Items 6-8. 6-8
Items 9-12. 9-12
Items 13-15. 13-15
Items 16-19. 16-19
C107016 ADL0225 ADL02-Total ADCS-ADL Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Score Living Inventory, Severe Dementia Version - Total Score. Dementia - Total Score
page 66 of 1925
ADL02TN (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory Severe Dementia
Version Questionnaire Test Name)
C106652 ADL02TN
Code Value
C106993 ADL02-Clear Dishes ADL02-Clear Dishes Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - Did {S} Dementia - Clear Dishes
clear the dishes from the table after a meal or snack? After Meal or Snack
C106994 ADL02-Clear Dishes Usual ADL02-Clear Dishes Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Performance Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
Clearing Dishes
C107000 ADL02-Dispose Garbage ADL02-Dispose Garbage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Usual Performance Usual Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
Garbage Disposal
C106999 ADL02-Dispose of ADL02-Dispose of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Garbage Garbage Living Inventory, Severe Dementia Version - In the past 4 Dementia - Dispose of
weeks, did {S} dispose of garbage or litter in an Garbage in Appropriate
appropriate place or container at home? Place at Home
C106995 ADL02-Find Belongings ADL02-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Find Personal
weeks, did {S} usually manage to find his/her personal Belongings at Home
belongings at home?
C106996 ADL02-Find Belongings ADL02-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Usual Performance Usual Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
Finding Personal
Belonging at Home
C107002 ADL02-Get Around ADL02-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Optimal Performance Optimal Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
best describes {S} optimal performance. Optimal Performance of
Getting Around Outside of
Home
C107001 ADL02-Get Around ADL02-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Outside Home Outside Home Living Inventory, Severe Dementia Version - In the past 4 Dementia - Get Around
weeks, did {S} get around (or travel) outside of his/her Outside Home
home?
C106986 ADL02-Highest Telephone ADL02-Highest Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Use Performance Use Performance Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
Telephone Use
C107005 ADL02-Left at Home for 1 ADL02-Left at Home for 1 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Hour or Longer Hour or Longer Living Inventory, Severe Dementia Version - Was {S} Dementia - Alone at
left: at home for an hour or longer during the day? Home for One Hour or
Longer
C107006 ADL02-Left at Home for ADL02-Left at Home for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Less Than 1 Hour Less Than 1 Hour Living Inventory, Severe Dementia Version - Was {S} Dementia - Alone at
left: at home for less than 1 hour during the day? Home for Less Than One
Hour
C107004 ADL02-Left Away From ADL02-Left Away From Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Home Home Living Inventory, Severe Dementia Version - Was {S} Dementia - Alone Away
left: away from home for 15 minutes or longer, during From Home for Fifteen
the day? Minutes or Longer
C107003 ADL02-Left On His/Her ADL02-Left On His/Her Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Own Own Living Inventory, Severe Dementia Version - In the past 4 Dementia - Subject Left
weeks, was {S} ever left on his/her own? on Their Own
C106997 ADL02-Obtain Beverage ADL02-Obtain Beverage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Obtain
weeks, did {S} obtain a hot or cold beverage for Beverage for Self
him/herself?
C106998 ADL02-Obtain Beverage ADL02-Obtain Beverage Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Highest Perform Highest Perform Living Inventory, Severe Dementia Version - If yes, which Dementia - Description of
Obtaining Beverage
C106983 ADL02-Optimal Grooming ADL02-Optimal Grooming Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Performance Performance Living Inventory, Severe Dementia Version - Regarding Dementia - Description of
grooming, in the past 4 weeks, which best describes {S} Optimal Performance of
optimal performance? Grooming
page 67 of 1925
C106652 ADL02TN
Code Value
C106980 ADL02-Optimal Walking ADL02-Optimal Walking Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
walking (or getting around in a wheelchair) in the past 4 Optimal Performance of
weeks, which best describes {S} optimal performance? Walking
C106991 ADL02-Pay Attention to ADL02-Pay Attention to Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Conversation Conversation Living Inventory, Severe Dementia Version - In the past 4 Dementia - Pay Attention
weeks, did {S} ever appear to pay attention to to Conversation
conversation or small talk for at least 5 minutes?
C107007 ADL02-Run Water Faucet ADL02-Run Water Faucet Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
to Wash to Wash Living Inventory, Severe Dementia Version - In the past 4 Dementia - Turn On
weeks, did {S} usually run water from a faucet to wash Faucet to Wash Without
{S} hands or face without help? Help
C106988 ADL02-Select Television ADL02-Select Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Program Program Living Inventory, Severe Dementia Version - Did {S} Dementia - Select or Ask
usually select or ask for different programs or {S} for Television Program
favorite show?
C107011 ADL02-Sum 1 to 5 ADL02-Sum 1 to 5 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Items 1-5. 1-5
Items 13-15. 13-15
Items 16-19. 16-19
Items 6-8. 6-8
Items 9-12. 9-12
C106989 ADL02-Talk About TV ADL02-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Content While Watch Content While Watch Living Inventory, Severe Dementia Version - Did {S} Dementia - Talk About TV
usually talk about the content of a program while Content While Watching
watching it?
C106990 ADL02-Talk About TV ADL02-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Content Within a Day Content Within a Day Living Inventory, Severe Dementia Version - Did {S} talk Dementia - Talk About TV
about the content of a program within a day (24 hours) Content Within a Day
after watching it? After Watching
C107016 ADL02-Total ADCS-ADL ADL02-Total ADCS-ADL Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Score Score Living Inventory, Severe Dementia Version - Total Score. Dementia - Total Score
C107008 ADL02-Turn Off Faucet ADL02-Turn Off Faucet Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Turn Off
weeks, did {S} usually turn off the faucet after finishing Faucet After Wash
running water without help? Without Help
C107010 ADL02-Turn Off Light ADL02-Turn Off Light Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Turn Off Light
weeks, did {S} usually turn off lights without help when Without Help Leaving
leaving a room or going to sleep? Room
C107009 ADL02-Turn On Light ADL02-Turn On Light Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Turn On Light
weeks, did {S} usually turn on a light without help when Without Help Entering
entering a dark room or area? Room
C106985 ADL02-Use a Telephone ADL02-Use a Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Use a
weeks, did {S} use a telephone? Telephone
C106982 ADL02-Usual Bathing ADL02-Usual Bathing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
bathing, in the past 4 weeks, which best describes {S} Usual Performance of
usual performance? Bathing
C106981 ADL02-Usual ADL02-Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Bowel/Bladder Function Bowel/Bladder Function Living Inventory, Severe Dementia Version - Regarding Dementia - Usual Bowel
bowel and bladder function at the toilet, which best and Bladder Function at
describes {S} usual performance during the past 4 Toilet
weeks?
page 68 of 1925
C106652 ADL02TN
Code Value
C106992 ADL02-Usual ADL02-Usual Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Conversation Participation Conversation Participation Living Inventory, Severe Dementia Version - If yes, which Dementia - Usual
best describes {S} usual degree of participation. Conversation Participation
C106979 ADL02-Usual Eating ADL02-Usual Eating Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
eating, which best describes {S} usual performance Usual Performance of
during the last 4 weeks? Eating
C106984 ADL02-Usual Physically ADL02-Usual Physically Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Dressing Perform Dressing Perform Living Inventory, Severe Dementia Version - Regarding Dementia - Description of
physically getting dressed, which best describes {S} Usual Performance of
usual performance in the past 4 weeks? Physically Getting
Dressed
C106987 ADL02-Watch Television ADL02-Watch Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL Severe
Living Inventory, Severe Dementia Version - In the past 4 Dementia - Watch
weeks, did {S} watch television? Television
page 69 of 1925
ADL03TC (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory MCI Version
Questionnaire Test Code)
C106651 ADL03TC
Code Value
C106891 ADL0301 ADL03-Find Personal Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Find
Belongings Living Inventory, MCI Version - In the past 4 weeks, did Personal Belongings
{S} usually manage to find his/her personal belongings
at home?
C106892 ADL0301A ADL03-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Usual Performance Living Inventory, MCI Version - If yes, which best Description of Usual
describes how he /she usually performed. Performance of Finding
Belongings
C106893 ADL0302 ADL03-Select First Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Select
Clothes for the Day Living Inventory, MCI Version - In the past 4 weeks, did First Clothes for the Day
{S} select his/her first set of clothes for the day?
C106894 ADL0302A ADL03-Usual Dressing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Performance Living Inventory, MCI Version - If yes, which best Description of Usual
describes his/her usual performance. Performance of Selecting
First Clothes for the Day
C106895 ADL0303 ADL03-Usual Physically Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Dressing Perform Living Inventory, MCI Version - Regarding physically Description of Usual
getting dressed, which best describes his/her usual Performance of Physically
performance in the past 4 weeks. Getting Dressed
C106896 ADL0304 ADL03-Clean Room Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Clean
Living Inventory, MCI Version - In the past 4 weeks, did Room
{S} clean a living-, sitting-, or family room?
C106897 ADL0304A ADL03-Clean Room Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
describes how he/she usually performed. Performance of Cleaning
Room
C106898 ADL0305 ADL03-Balance Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Balance
Checkbook Living Inventory, MCI Version - In the past 4 weeks, did Checkbook
{S} balance his/her checkbook or credit card statement?
C106899 ADL0305A ADL03-Balance Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Checkbook Performance Living Inventory, MCI Version - If yes, which best Description of Usual
describes how he/she usually performed. Performance of Balancing
Checkbook
C106900 ADL0306 ADL03-Write Things Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Write
Down Living Inventory, MCI Version - In the past 4 weeks, did Things Down
{S} ever write things down?
C106901 ADL0306A ADL03-Most Complicated Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Writings Living Inventory, MCI Version - If yes, which best Description of Usual
describes the most complicated things that he/she wrote. Performance of Most
Complicated Things
Written
C106902 ADL0307 ADL03-Clean Laundry Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Clean
Living Inventory, MCI Version - In the past 4 weeks, did Laundry
{S} clean a load of laundry?
C106903 ADL0307A ADL03-Laundry Cleaning Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
describes how he/she usually performed. Performance of Clean
Laundry
C106904 ADL0308 ADL03-Keep Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Keep
Appointments Living Inventory, MCI Version - In the past 4 weeks, did Appointments
{S} keep appointments or meetings with other people,
such as relatives, a doctor, the hairdresser, etc.?
C106905 ADL0308A ADL03-Aware of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Appointment Ahead of Living Inventory, MCI Version - If yes, which best Description of Awareness
Time describes his/her awareness of the meeting ahead of of the Meeting Ahead of
time. Time
C106906 ADL0309 ADL03-Use a Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use a
Living Inventory, MCI Version - In the past 4 weeks, did Telephone
{S} use a telephone?
C106907 ADL0309A ADL03-Highest Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Use Performance Living Inventory, MCI Version - If yes, which best Description of Highest
describes his/her highest level of performance. Level of Performance of
Telephone Use
page 70 of 1925
C106651 ADL03TC
Code Value
C106908 ADL0310 ADL03-Make a Meal Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Make a
Living Inventory, MCI Version - In the past 4 weeks, did Meal or Snack
{S} make him/herself a meal or snack at home?
C106909 ADL0310A ADL03-Highest Level of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Food Preparation Living Inventory, MCI Version - If yes, which best Description of Highest
describes his/her highest level of food preparation. Level of Food Preparation
C106910 ADL0311 ADL03-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Travel
Outside Home Living Inventory, MCI Version - In the past 4 weeks, did Outside Home
{S} get around (or travel) outside of his/her home?
C106911 ADL0311A ADL03-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Optimal Performance Living Inventory, MCI Version - If yes, which best Description of Optimal
describes his/her optimal performance. Performance of Travelling
Outside Home
C106912 ADL0312 ADL03-Talk About Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Current Events Living Inventory, MCI Version - In the past 4 weeks, did About Current Events
{S} talk about current events?
C106913 ADL0312A ADL03-Regional, Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
National, International Living Inventory, MCI Version - If yes, did {S} talk about About Regional, National
regional, national or international events? or International Events
C106914 ADL0312B ADL03-Talk About Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Outside Events Living Inventory, MCI Version - Did {S} talk about events About Outside Home
outside home involving family, friends, or neighbors? Events
C106915 ADL0312C ADL03-Talk About at Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Home Events Living Inventory, MCI Version - Did {S} talk about events About at Home Events
that occurred at home that he/she took part in or
watched?
C106916 ADL0312D ADL03-Talk Without Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Repeating Living Inventory, MCI Version - Did {S} converse without Converse Without
repeating him/herself, or asking the same questions Repeating
repeatedly?
C106917 ADL0313 ADL03-Read More Than 5 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Read
Minutes Living Inventory, MCI Version - In the past 4 weeks, did More Than 5 Minutes
{S} read a magazine, newspaper or book for more than 5
minutes at a time?
C106918 ADL0313A ADL03-Select/Ask for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Select
Something to Read Living Inventory, MCI Version - Did {S} usually select or or Ask for Something to
ask for something to read? Read
C106919 ADL0313B ADL03-Talk Within 1 Hour Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
After Reading Living Inventory, MCI Version - Did {S} usually talk Within 1 Hour After
about what he/she read while or shortly after reading Reading
(less than 1 hour)?
C106920 ADL0313C ADL03-Talk Within 1 Day Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
After Reading Living Inventory, MCI Version - Did {S} usually talk Within 24 Hours After
about what he/she read 1-24 hours after reading? Reading
C106921 ADL0314 ADL03-Watch Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Watch
Living Inventory, MCI Version - In the past 4 weeks, did Television
{S} watch television?
C106922 ADL0314A ADL03-Select Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Select
Program Living Inventory, MCI Version - Did {S} usually select or or Ask for Programs or
ask for different programs or his/her favorite show? Show
C106923 ADL0314B ADL03-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Content While Watch Living Inventory, MCI Version - Did {S} usually talk About Content of Program
about the content of a program while watching it? While Watching
C106924 ADL0314C ADL03-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Content Within a Day Living Inventory, MCI Version - Did {S} talk about the About Content of Program
content of a program within a day (24 hours) after After Watching Within a
watching it? Day
C106925 ADL0315 ADL03-Go Shopping Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Go
Living Inventory, MCI Version - In the past 4 weeks, did Shopping At a Store
{S} ever go shopping at a store?
C106926 ADL0315A ADL03-Select Items Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Select
Without Help Living Inventory, MCI Version - Did {S} usually select Correct Items Without
correct items without supervision or help? Help
page 71 of 1925
C106651 ADL03TC
Code Value
C106927 ADL0315B ADL03-Pay Items On Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Pay for
His/Her Own Living Inventory, MCI Version - Did {S} usually pay for Items on His or Her Own
items on his/her own?
C106928 ADL0316 ADL03-Left On His/Her Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Left on
Own Living Inventory, MCI Version - In the past 4 weeks, was His or Her Own
{S} ever left on his/her own?
C106929 ADL0316A ADL03-Left Away From Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Left
Home Living Inventory, MCI Version - Was {S} left away from Away From Home Longer
home, for 15 minutes or longer, during the day? Than 15 Minutes
C106930 ADL0316B ADL03-Left at Home for 1 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Left at
Hour or Longer Living Inventory, MCI Version - Was {S} left at home, for Home Longer Than an
an hour or longer, during the day? Hour
C106931 ADL0316C ADL03-Left at Home for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Left at
Less Than 1 Hour Living Inventory, MCI Version - Was {S} left at home, for Home Less Than an Hour
less than 1 hour, during the day?
C106932 ADL0317 ADL03-Use Household Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Appliance Living Inventory, MCI Version - In the past 4 weeks, did Household Appliance
{S} use a household appliance to do chores?
C107089 ADL0317A ADL03-Appliance: Washer Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Living Inventory, MCI Version - Check all that were used: Household Appliance:
washer. Washer
C107090 ADL0317B ADL03-Appliance: Dryer Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
dryer. Dryer
C107091 ADL0317C ADL03-Appliance: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Vacuum Living Inventory, MCI Version - Check all that were used: Household Appliance:
vacuum. Vacuum
C106933 ADL0317D ADL03-Appliance: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Dishwasher Living Inventory, MCI Version - Check all that were used: Household Appliance:
dishwasher. Dishwasher
C106934 ADL0317E ADL03-Appliance: Power Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Tools Living Inventory, MCI Version - Check all that were used: Household Appliance:
power tool (s). Power Tools
C106935 ADL0317F ADL03-Appliance: Toaster Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Oven Living Inventory, MCI Version - Check all that were used: Household Appliance:
toaster oven. Toaster Oven
C106936 ADL0317G ADL03-Appliance: Range Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
range. Range
C106937 ADL0317H ADL03-Appliance: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Microwave Living Inventory, MCI Version - Check all that were used: Household Appliance:
microwave. Microwave
C106938 ADL0317I ADL03-Appliance: Food Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Processor Living Inventory, MCI Version - Check all that were used: Household Appliance:
food processor. Food Processor
C106939 ADL0317J ADL03-Appliance: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
other. Other
C106940 ADL0317K ADL03-Appliance: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Specify Living Inventory, MCI Version - Check all that were used: Household Appliance:
other specify. Other Specify
C106941 ADL0317L ADL03-Use Common Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Used Appliances (q17a) Living Inventory, MCI Version - For the 1 or 2 most Description of Usual Use
commonly used appliances, which best describes how {S} of Commonly Used
usually used them. Appliances
C106942 ADL0318 ADL03-Perform Pastime Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Living Inventory, MCI Version - In the past 4 weeks, did Pastime, Hobby or Game
{S} perform a pastime, hobby or game?
C106943 ADL0318A ADL03-Pastime: Card or Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Board Games Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: card or board games. Card or Board Games
C106944 ADL0318B ADL03-Pastime: Bingo Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: bingo. Bingo
page 72 of 1925
C106651 ADL03TC
Code Value
C106945 ADL0318C ADL03-Pastime: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Crosswords Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: crosswords. Crosswords
C106946 ADL0318D ADL03-Pastime: Art Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: art. Art
C106947 ADL0318E ADL03-Pastime: Musical Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Instrument Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: musical instrument. Musical Instrument
C106948 ADL0318F ADL03-Pastime: Knitting Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: knitting. Knitting
C106949 ADL0318G ADL03-Pastime: Sewing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: sewing. Sewing
C106950 ADL0318H ADL03-Pastime: Reading Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: reading. Reading
C106951 ADL0318I ADL03-Pastime: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Gardening Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: gardening. Gardening
C106952 ADL0318J ADL03-Pastime: Golf Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: golf. Golf
C106953 ADL0318K ADL03-Pastime: Tennis Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: tennis. Tennis
C106954 ADL0318L ADL03-Pastime: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Workshop Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: workshop. Workshop
C106955 ADL0318M ADL03-Pastime: Fishing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: fishing. Fishing
C106956 ADL0318N ADL03-Pastime: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: other. Other
C106957 ADL0318O ADL03-Pastime: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Specify Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: other specify. Other Specify
C106958 ADL0318P ADL03-Hobbies Needed Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Require
Help (Q18a) Living Inventory, MCI Version - Did {S} require Help to Perform Hobbies
supervision, or help, to perform any of these hobbies?
C106959 ADL0318Q ADL03-Hobbies Unable to Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - List
Perform (Q18b) Living Inventory, MCI Version - List any hobby (ies) that Hobbies Lost Ability to
the subject has lost the ability to perform. Perform
C106960 ADL0319 ADL03-Drive Car Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Drive a
Living Inventory, MCI Version - In the past 4 weeks, did Car
{S} drive a car?
C106961 ADL0319A ADL03-Drive Car Optimal Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Performance Living Inventory, MCI Version - If yes, which best Description of Optimal
describes his/her optimal performance. Performance of Driving
Car
C106962 ADL0320 ADL03-Take Medications Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Take
Regularly Living Inventory, MCI Version - During the past 4 weeks, Medications Regularly
did {S} take his/her medications regularly?
C106963 ADL0320A ADL03-Take Medications Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Performance Living Inventory, MCI Version - If yes, was this. Description of Taking
Medications Regularly
C106964 ADL0321 ADL03-Complete Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Carry
Complex Activities Living Inventory, MCI Version - During the past 4 weeks, Through Complex
did {S} usually carry through complex or time-consuming Activities to Completion
activities to completion?
page 73 of 1925
C106651 ADL03TC
Code Value
C106965 ADL0321A ADL03-Extent Needed Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Reminders Living Inventory, MCI Version - If yes, which best Description of Extent
describes extent to which he/she needed reminders. Needing Reminder
C106966 ADL0322 ADL03-Initiate Complex Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Initiate
Activities Living Inventory, MCI Version - During the past 4 weeks, Complex Daily Activities
to what extent did {S} initiate complex daily activities or
projects (e.g., hobbies, travel)?
C106967 ADL0323 ADL03-Time to Complete Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Time
Complex Tasks Living Inventory, MCI Version - During the past 4 weeks, Taken to Complete
how long did it usually take {S} to complete complex or Complex Activities
time-consuming tasks or activities?
C106968 ADL0324 ADL03-Extenuating Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Circumstances Living Inventory, MCI Version - Has an extenuating Extenuating Circumstance
circumstance (such as a physical health problem, change
in residence, change in support network, death of a
family member, etc.) contributed to a recent alteration in
the subject's activities of daily living?
C106969 ADL0324A ADL03-Explain Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Explain
Circumstance Living Inventory, MCI Version - If yes, explain. Extenuating Circumstance
C107092 ADL0325 ADL03-Total Points for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Points
'Don't Know' Living Inventory, MCI Version - Were any questions (1- for Questions (1-18)
18) answered 'Don't Know'? If yes, calculate total points Answered 'Don't Know'
for 'Don't Know'.
C106970 ADL0326 ADL03-Subscore for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Items 1 to 3 Living Inventory, MCI Version - Subscore for Page 1. Subscore for Items 1 to 3
Items 4 to 7 Living Inventory, MCI Version - Subscore for Page 2. Subscore for Items 4 to 7
Items 8 to 10 Living Inventory, MCI Version - Subscore for Page 3. Subscore for Items 8 to
10
Items 11 to 12d Living Inventory, MCI Version - Subscore for Page 4. Subscore for Items 11 to
12
Items 13 to 14c Living Inventory, MCI Version - Subscore for Page 5. Subscore for Items 13 to
14
Items 15 to 16c Living Inventory, MCI Version - Subscore for Page 6. Subscore for Items 15 to
16
C106976 ADL0332 ADL03-Subscore for Item Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
17 Living Inventory, MCI Version - Subscore for Page 7. Subscore for Item 17
C106977 ADL0333 ADL03-Subscore for Item Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
18 Living Inventory, MCI Version - Subscore for Page 8. Subscore for Item 18
C106978 ADL0334 ADL03-Total ADCS-ADL Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - ADL
Score Living Inventory, MCI Version - Total Score. Total Score
page 74 of 1925
ADL03TN (Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory MCI Version
C106650 ADL03TN
Code Value
C106933 ADL03-Appliance: ADL03-Appliance: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Dishwasher Dishwasher Living Inventory, MCI Version - Check all that were used: Household Appliance:
dishwasher. Dishwasher
C107090 ADL03-Appliance: Dryer ADL03-Appliance: Dryer Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
dryer. Dryer
C106938 ADL03-Appliance: Food ADL03-Appliance: Food Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Processor Processor Living Inventory, MCI Version - Check all that were used: Household Appliance:
food processor. Food Processor
Microwave Microwave Living Inventory, MCI Version - Check all that were used: Household Appliance:
microwave. Microwave
C106939 ADL03-Appliance: Other ADL03-Appliance: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
other. Other
C106940 ADL03-Appliance: Other ADL03-Appliance: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Specify Specify Living Inventory, MCI Version - Check all that were used: Household Appliance:
other specify. Other Specify
C106934 ADL03-Appliance: Power ADL03-Appliance: Power Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Tools Tools Living Inventory, MCI Version - Check all that were used: Household Appliance:
power tool (s). Power Tools
C106936 ADL03-Appliance: Range ADL03-Appliance: Range Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
range. Range
C106935 ADL03-Appliance: Toaster ADL03-Appliance: Toaster Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Oven Oven Living Inventory, MCI Version - Check all that were used: Household Appliance:
toaster oven. Toaster Oven
Vacuum Vacuum Living Inventory, MCI Version - Check all that were used: Household Appliance:
vacuum. Vacuum
C107089 ADL03-Appliance: Washer ADL03-Appliance: Washer Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
washer. Washer
C106905 ADL03-Aware of ADL03-Aware of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Appointment Ahead of Appointment Ahead of Living Inventory, MCI Version - If yes, which best Description of Awareness
Time Time describes his/her awareness of the meeting ahead of of the Meeting Ahead of
time. Time
C106898 ADL03-Balance ADL03-Balance Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Balance
Checkbook Checkbook Living Inventory, MCI Version - In the past 4 weeks, did Checkbook
{S} balance his/her checkbook or credit card statement?
C106899 ADL03-Balance ADL03-Balance Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Checkbook Performance Checkbook Performance Living Inventory, MCI Version - If yes, which best Description of Usual
describes how he/she usually performed. Performance of Balancing
Checkbook
C106902 ADL03-Clean Laundry ADL03-Clean Laundry Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Clean
Living Inventory, MCI Version - In the past 4 weeks, did Laundry
{S} clean a load of laundry?
C106896 ADL03-Clean Room ADL03-Clean Room Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Clean
Living Inventory, MCI Version - In the past 4 weeks, did Room
{S} clean a living-, sitting-, or family room?
C106897 ADL03-Clean Room ADL03-Clean Room Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Performance Performance Living Inventory, MCI Version - If yes, which best Description of Usual
describes how he/she usually performed. Performance of Cleaning
Room
C106964 ADL03-Complete ADL03-Complete Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Carry
Complex Activities Complex Activities Living Inventory, MCI Version - During the past 4 weeks, Through Complex
did {S} usually carry through complex or time-consuming Activities to Completion
activities to completion?
page 75 of 1925
C106650 ADL03TN
Code Value
C106960 ADL03-Drive Car ADL03-Drive Car Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Drive a
Living Inventory, MCI Version - In the past 4 weeks, did Car
{S} drive a car?
C106961 ADL03-Drive Car Optimal ADL03-Drive Car Optimal Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Performance Performance Living Inventory, MCI Version - If yes, which best Description of Optimal
describes his/her optimal performance. Performance of Driving
Car
C106969 ADL03-Explain ADL03-Explain Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Explain
Circumstance Circumstance Living Inventory, MCI Version - If yes, explain. Extenuating Circumstance
C106965 ADL03-Extent Needed ADL03-Extent Needed Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Reminders Reminders Living Inventory, MCI Version - If yes, which best Description of Extent
describes extent to which he/she needed reminders. Needing Reminder
C106968 ADL03-Extenuating ADL03-Extenuating Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Circumstances Circumstances Living Inventory, MCI Version - Has an extenuating Extenuating Circumstance
circumstance (such as a physical health problem, change
in residence, change in support network, death of a
family member, etc.) contributed to a recent alteration in
the subject's activities of daily living?
C106892 ADL03-Find Belongings ADL03-Find Belongings Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Usual Performance Usual Performance Living Inventory, MCI Version - If yes, which best Description of Usual
describes how he /she usually performed. Performance of Finding
Belongings
C106891 ADL03-Find Personal ADL03-Find Personal Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Find
Belongings Belongings Living Inventory, MCI Version - In the past 4 weeks, did Personal Belongings
{S} usually manage to find his/her personal belongings
at home?
C106911 ADL03-Get Around ADL03-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Optimal Performance Optimal Performance Living Inventory, MCI Version - If yes, which best Description of Optimal
describes his/her optimal performance. Performance of Travelling
Outside Home
C106910 ADL03-Get Around ADL03-Get Around Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Travel
Outside Home Outside Home Living Inventory, MCI Version - In the past 4 weeks, did Outside Home
{S} get around (or travel) outside of his/her home?
C106925 ADL03-Go Shopping ADL03-Go Shopping Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Go
Living Inventory, MCI Version - In the past 4 weeks, did Shopping At a Store
{S} ever go shopping at a store?
C106909 ADL03-Highest Level of ADL03-Highest Level of Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Food Preparation Food Preparation Living Inventory, MCI Version - If yes, which best Description of Highest
describes his/her highest level of food preparation. Level of Food Preparation
C106907 ADL03-Highest Telephone ADL03-Highest Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Use Performance Use Performance Living Inventory, MCI Version - If yes, which best Description of Highest
describes his/her highest level of performance. Level of Performance of
Telephone Use
C106958 ADL03-Hobbies Needed ADL03-Hobbies Needed Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Require
Help (Q18a) Help (Q18a) Living Inventory, MCI Version - Did {S} require Help to Perform Hobbies
supervision, or help, to perform any of these hobbies?
C106959 ADL03-Hobbies Unable to ADL03-Hobbies Unable to Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - List
Perform (Q18b) Perform (Q18b) Living Inventory, MCI Version - List any hobby (ies) that Hobbies Lost Ability to
the subject has lost the ability to perform. Perform
C106966 ADL03-Initiate Complex ADL03-Initiate Complex Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Initiate
Activities Activities Living Inventory, MCI Version - During the past 4 weeks, Complex Daily Activities
to what extent did {S} initiate complex daily activities or
projects (e.g., hobbies, travel)?
C106904 ADL03-Keep ADL03-Keep Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Keep
Appointments Appointments Living Inventory, MCI Version - In the past 4 weeks, did Appointments
{S} keep appointments or meetings with other people,
such as relatives, a doctor, the hairdresser, etc.?
C106903 ADL03-Laundry Cleaning ADL03-Laundry Cleaning Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
describes how he/she usually performed. Performance of Clean
Laundry
C106930 ADL03-Left at Home for 1 ADL03-Left at Home for 1 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Left at
Hour or Longer Hour or Longer Living Inventory, MCI Version - Was {S} left at home, for Home Longer Than an
an hour or longer, during the day? Hour
page 76 of 1925
C106650 ADL03TN
Code Value
C106931 ADL03-Left at Home for ADL03-Left at Home for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Left at
Less Than 1 Hour Less Than 1 Hour Living Inventory, MCI Version - Was {S} left at home, for Home Less Than an Hour
less than 1 hour, during the day?
C106929 ADL03-Left Away From ADL03-Left Away From Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Left
Home Home Living Inventory, MCI Version - Was {S} left away from Away From Home Longer
home, for 15 minutes or longer, during the day? Than 15 Minutes
C106928 ADL03-Left On His/Her ADL03-Left On His/Her Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Left on
Own Own Living Inventory, MCI Version - In the past 4 weeks, was His or Her Own
{S} ever left on his/her own?
C106908 ADL03-Make a Meal ADL03-Make a Meal Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Make a
Living Inventory, MCI Version - In the past 4 weeks, did Meal or Snack
{S} make him/herself a meal or snack at home?
C106901 ADL03-Most Complicated ADL03-Most Complicated Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Writings Writings Living Inventory, MCI Version - If yes, which best Description of Usual
describes the most complicated things that he/she wrote. Performance of Most
Complicated Things
Written
C106946 ADL03-Pastime: Art ADL03-Pastime: Art Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: art. Art
C106944 ADL03-Pastime: Bingo ADL03-Pastime: Bingo Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: bingo. Bingo
C106943 ADL03-Pastime: Card or ADL03-Pastime: Card or Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Board Games Board Games Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: card or board games. Card or Board Games
C106945 ADL03-Pastime: ADL03-Pastime: Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Crosswords Crosswords Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: crosswords. Crosswords
C106955 ADL03-Pastime: Fishing ADL03-Pastime: Fishing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: fishing. Fishing
Gardening Gardening Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: gardening. Gardening
C106952 ADL03-Pastime: Golf ADL03-Pastime: Golf Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: golf. Golf
C106948 ADL03-Pastime: Knitting ADL03-Pastime: Knitting Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: knitting. Knitting
C106947 ADL03-Pastime: Musical ADL03-Pastime: Musical Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Instrument Instrument Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: musical instrument. Musical Instrument
C106956 ADL03-Pastime: Other ADL03-Pastime: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: other. Other
C106957 ADL03-Pastime: Other ADL03-Pastime: Other Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Specify Specify Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: other specify. Other Specify
C106950 ADL03-Pastime: Reading ADL03-Pastime: Reading Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: reading. Reading
C106949 ADL03-Pastime: Sewing ADL03-Pastime: Sewing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: sewing. Sewing
C106953 ADL03-Pastime: Tennis ADL03-Pastime: Tennis Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
he/she perform: tennis. Tennis
Workshop Workshop Living Inventory, MCI Version - Which pastimes did Pastime, Hobby or Game:
he/she perform: workshop. Workshop
page 77 of 1925
C106650 ADL03TN
Code Value
C106927 ADL03-Pay Items On ADL03-Pay Items On Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Pay for
His/Her Own His/Her Own Living Inventory, MCI Version - Did {S} usually pay for Items on His or Her Own
items on his/her own?
C106942 ADL03-Perform Pastime ADL03-Perform Pastime Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Perform
Living Inventory, MCI Version - In the past 4 weeks, did Pastime, Hobby or Game
{S} perform a pastime, hobby or game?
C106917 ADL03-Read More Than 5 ADL03-Read More Than 5 Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Read
Minutes Minutes Living Inventory, MCI Version - In the past 4 weeks, did More Than 5 Minutes
{S} read a magazine, newspaper or book for more than 5
minutes at a time?
C106913 ADL03-Regional, ADL03-Regional, Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
National, International National, International Living Inventory, MCI Version - If yes, did {S} talk about About Regional, National
regional, national or international events? or International Events
C106893 ADL03-Select First ADL03-Select First Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Select
Clothes for the Day Clothes for the Day Living Inventory, MCI Version - In the past 4 weeks, did First Clothes for the Day
{S} select his/her first set of clothes for the day?
C106926 ADL03-Select Items ADL03-Select Items Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Select
Without Help Without Help Living Inventory, MCI Version - Did {S} usually select Correct Items Without
correct items without supervision or help? Help
C106922 ADL03-Select Television ADL03-Select Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Select
Program Program Living Inventory, MCI Version - Did {S} usually select or or Ask for Programs or
ask for different programs or his/her favorite show? Show
C106918 ADL03-Select/Ask for ADL03-Select/Ask for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Select
Something to Read Something to Read Living Inventory, MCI Version - Did {S} usually select or or Ask for Something to
ask for something to read? Read
C106976 ADL03-Subscore for Item ADL03-Subscore for Item Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
17 17 Living Inventory, MCI Version - Subscore for Page 7. Subscore for Item 17
C106977 ADL03-Subscore for Item ADL03-Subscore for Item Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
18 18 Living Inventory, MCI Version - Subscore for Page 8. Subscore for Item 18
C106970 ADL03-Subscore for ADL03-Subscore for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Items 1 to 3 Items 1 to 3 Living Inventory, MCI Version - Subscore for Page 1. Subscore for Items 1 to 3
Items 11 to 12d Items 11 to 12d Living Inventory, MCI Version - Subscore for Page 4. Subscore for Items 11 to
12
Items 13 to 14c Items 13 to 14c Living Inventory, MCI Version - Subscore for Page 5. Subscore for Items 13 to
14
Items 15 to 16c Items 15 to 16c Living Inventory, MCI Version - Subscore for Page 6. Subscore for Items 15 to
16
Items 4 to 7 Items 4 to 7 Living Inventory, MCI Version - Subscore for Page 2. Subscore for Items 4 to 7
Items 8 to 10 Items 8 to 10 Living Inventory, MCI Version - Subscore for Page 3. Subscore for Items 8 to
10
C106963 ADL03-Take Medications ADL03-Take Medications Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Performance Performance Living Inventory, MCI Version - If yes, was this. Description of Taking
Medications Regularly
C106962 ADL03-Take Medications ADL03-Take Medications Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Take
Regularly Regularly Living Inventory, MCI Version - During the past 4 weeks, Medications Regularly
did {S} take his/her medications regularly?
C106915 ADL03-Talk About at ADL03-Talk About at Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Home Events Home Events Living Inventory, MCI Version - Did {S} talk about events About at Home Events
that occurred at home that he/she took part in or
watched?
C106912 ADL03-Talk About ADL03-Talk About Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Current Events Current Events Living Inventory, MCI Version - In the past 4 weeks, did About Current Events
{S} talk about current events?
C106914 ADL03-Talk About ADL03-Talk About Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Outside Events Outside Events Living Inventory, MCI Version - Did {S} talk about events About Outside Home
outside home involving family, friends, or neighbors? Events
page 78 of 1925
C106650 ADL03TN
Code Value
C106923 ADL03-Talk About TV ADL03-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Content While Watch Content While Watch Living Inventory, MCI Version - Did {S} usually talk About Content of Program
about the content of a program while watching it? While Watching
C106924 ADL03-Talk About TV ADL03-Talk About TV Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
Content Within a Day Content Within a Day Living Inventory, MCI Version - Did {S} talk about the About Content of Program
content of a program within a day (24 hours) after After Watching Within a
watching it? Day
C106920 ADL03-Talk Within 1 Day ADL03-Talk Within 1 Day Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
After Reading After Reading Living Inventory, MCI Version - Did {S} usually talk Within 24 Hours After
about what he/she read 1-24 hours after reading? Reading
C106919 ADL03-Talk Within 1 Hour ADL03-Talk Within 1 Hour Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Talk
After Reading After Reading Living Inventory, MCI Version - Did {S} usually talk Within 1 Hour After
about what he/she read while or shortly after reading Reading
(less than 1 hour)?
C106916 ADL03-Talk Without ADL03-Talk Without Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Repeating Repeating Living Inventory, MCI Version - Did {S} converse without Converse Without
repeating him/herself, or asking the same questions Repeating
repeatedly?
C106967 ADL03-Time to Complete ADL03-Time to Complete Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Time
Complex Tasks Complex Tasks Living Inventory, MCI Version - During the past 4 weeks, Taken to Complete
how long did it usually take {S} to complete complex or Complex Activities
time-consuming tasks or activities?
C106978 ADL03-Total ADCS-ADL ADL03-Total ADCS-ADL Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - ADL
Score Score Living Inventory, MCI Version - Total Score. Total Score
C107092 ADL03-Total Points for ADL03-Total Points for Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Points
'Don't Know' 'Don't Know' Living Inventory, MCI Version - Were any questions (1- for Questions (1-18)
18) answered 'Don't Know'? If yes, calculate total points Answered 'Don't Know'
for 'Don't Know'.
C106906 ADL03-Use a Telephone ADL03-Use a Telephone Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use a
Living Inventory, MCI Version - In the past 4 weeks, did Telephone
{S} use a telephone?
C106941 ADL03-Use Common ADL03-Use Common Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Used Appliances (q17a) Used Appliances (q17a) Living Inventory, MCI Version - For the 1 or 2 most Description of Usual Use
commonly used appliances, which best describes how {S} of Commonly Used
usually used them. Appliances
C106932 ADL03-Use Household ADL03-Use Household Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Use
Appliance Appliance Living Inventory, MCI Version - In the past 4 weeks, did Household Appliance
{S} use a household appliance to do chores?
C106894 ADL03-Usual Dressing ADL03-Usual Dressing Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
describes his/her usual performance. Performance of Selecting
First Clothes for the Day
C106895 ADL03-Usual Physically ADL03-Usual Physically Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI -
Dressing Perform Dressing Perform Living Inventory, MCI Version - Regarding physically Description of Usual
getting dressed, which best describes his/her usual Performance of Physically
performance in the past 4 weeks. Getting Dressed
C106921 ADL03-Watch Television ADL03-Watch Television Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Watch
Living Inventory, MCI Version - In the past 4 weeks, did Television
{S} watch television?
C106900 ADL03-Write Things ADL03-Write Things Alzheimer's Disease Cooperative Study-Activities of Daily ADCS-ADL MCI - Write
Down Down Living Inventory, MCI Version - In the past 4 weeks, did Things Down
{S} ever write things down?
page 79 of 1925
ADT01TC (Alcohol Use Disorder Identification Test: Self-Report Version Questionnaire Test Code)
C119060 ADT01TC
Code Value
C119108 ADT0101 ADT01-How Often Drink Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Have
Alcohol Version - How often do you have a drink containing Alcohol Drink
alcohol?
C119109 ADT0102 ADT01-Alcohol Drinks on Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Many
a Typical Day Version - How many drinks containing alcohol do you Alcohol Drinks on a
have on a typical day when you are drinking? Typical Day
C119110 ADT0103 ADT01-Six or More Drinks Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Have
One Occasion Version - How often do you have six or more drinks on Six or More Drinks
one occasion?
C119111 ADT0104 ADT01-Not Able Stop Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Drinking Once Start Version - How often during the last year have you found Year You Found Not Able
that you were not able to stop drinking once you had to Stop Drinking
started?
C119112 ADT0105 ADT01-Failed to Do as Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Expected Version - How often during the last year have you failed Year You Failed to Do
to do what was normally expected of you because of Normally Expected of You
drinking?
C119113 ADT0106 ADT01-Need Drink Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Morning After Drinking Version - How often during the last year have you needed Year Need a Drink in the
a first drink in the morning to get yourself going after a Morning to Get Going
heavy drinking session?
C119114 ADT0107 ADT01-Feeling of Guilt or Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Remorse Version - How often during the last year have you had a Year You Feel Guilt or
feeling of guilt or remorse after drinking? Remorse After Drinking
C119115 ADT0108 ADT01-Unable to Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Remember What Version - How often during the last year have you been Year You Unable to
Happened unable to remember what happened the night before Remember What
because of your drinking? Happened the Night
Before
C119116 ADT0109 ADT01-Injured Because Alcohol Use Disorder Identification Test: Self-Report AUDIT - Injured Because
of Your Drinking Version - Have you or someone else been injured because of Drinking
of your drinking?
C119117 ADT0110 ADT01-Suggested to Cut Alcohol Use Disorder Identification Test: Self-Report AUDIT - Concerned About
Down Version - Has a relative, friend, doctor, or other health Your Drinking
care worker been concerned about your drinking or
suggested you cut down?
C119118 ADT0111 ADT01-Total Alcohol Use Disorder Identification Test: Self-Report AUDIT - Total
Version - Total.
page 80 of 1925
ADT01TN (Alcohol Use Disorder Identification Test: Self-Report Version Questionnaire Test Name)
C119059 ADT01TN
Code Value
C119109 ADT01-Alcohol Drinks on ADT01-Alcohol Drinks on Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Many
a Typical Day a Typical Day Version - How many drinks containing alcohol do you Alcohol Drinks on a
have on a typical day when you are drinking? Typical Day
C119112 ADT01-Failed to Do as ADT01-Failed to Do as Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Expected Expected Version - How often during the last year have you failed Year You Failed to Do
to do what was normally expected of you because of Normally Expected of You
drinking?
C119114 ADT01-Feeling of Guilt or ADT01-Feeling of Guilt or Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Remorse Remorse Version - How often during the last year have you had a Year You Feel Guilt or
feeling of guilt or remorse after drinking? Remorse After Drinking
C119108 ADT01-How Often Drink ADT01-How Often Drink Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Have
Alcohol Alcohol Version - How often do you have a drink containing Alcohol Drink
alcohol?
C119116 ADT01-Injured Because ADT01-Injured Because Alcohol Use Disorder Identification Test: Self-Report AUDIT - Injured Because
of Your Drinking of Your Drinking Version - Have you or someone else been injured because of Drinking
of your drinking?
C119113 ADT01-Need Drink ADT01-Need Drink Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Morning After Drinking Morning After Drinking Version - How often during the last year have you needed Year Need a Drink in the
a first drink in the morning to get yourself going after a Morning to Get Going
heavy drinking session?
C119111 ADT01-Not Able Stop ADT01-Not Able Stop Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Drinking Once Start Drinking Once Start Version - How often during the last year have you found Year You Found Not Able
that you were not able to stop drinking once you had to Stop Drinking
started?
C119110 ADT01-Six or More Drinks ADT01-Six or More Drinks Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Have
One Occasion One Occasion Version - How often do you have six or more drinks on Six or More Drinks
one occasion?
C119117 ADT01-Suggested to Cut ADT01-Suggested to Cut Alcohol Use Disorder Identification Test: Self-Report AUDIT - Concerned About
Down Down Version - Has a relative, friend, doctor, or other health Your Drinking
care worker been concerned about your drinking or
suggested you cut down?
C119118 ADT01-Total ADT01-Total Alcohol Use Disorder Identification Test: Self-Report AUDIT - Total
Version - Total.
C119115 ADT01-Unable to ADT01-Unable to Alcohol Use Disorder Identification Test: Self-Report AUDIT - How Often Last
Remember What Remember What Version - How often during the last year have you been Year You Unable to
Happened Happened unable to remember what happened the night before Remember What
because of your drinking? Happened the Night
Before
page 81 of 1925
ADTC01TC (Alcohol Use Disorder Identification Test-Consumption Questions Questionnaire Test Code)
C119062 ADTC01TC
Code Value
C119119 ADTC0101 ADTC01-How Often Drink Alcohol Use Disorder Identification Test-Consumption AUDIT-C - How Often
Alcohol questions - How often do you have a drink containing Have Alcohol Drink
alcohol?
C119120 ADTC0102 ADTC01-Alcohol Drinks Alcohol Use Disorder Identification Test-Consumption AUDIT-C - How Many
on a Typical Day questions - How many standard drinks containing alcohol Alcohol Drinks on a
do you have on a typical day? Typical Day
C119121 ADTC0103 ADTC01-Six or More Alcohol Use Disorder Identification Test-Consumption AUDIT-C - How Often
Drinks One Occasion questions - How often do you have six or more drinks on Have Six or More Drinks
one occasion?
page 82 of 1925
ADTC01TN (Alcohol Use Disorder Identification Test-Consumption Questions Questionnaire Test
Name)
C119061 ADTC01TN
Code Value
C119120 ADTC01-Alcohol Drinks ADTC01-Alcohol Drinks Alcohol Use Disorder Identification Test-Consumption AUDIT-C - How Many
on a Typical Day on a Typical Day questions - How many standard drinks containing alcohol Alcohol Drinks on a
do you have on a typical day? Typical Day
C119119 ADTC01-How Often Drink ADTC01-How Often Drink Alcohol Use Disorder Identification Test-Consumption AUDIT-C - How Often
Alcohol Alcohol questions - How often do you have a drink containing Have Alcohol Drink
alcohol?
C119121 ADTC01-Six or More ADTC01-Six or More Alcohol Use Disorder Identification Test-Consumption AUDIT-C - How Often
Drinks One Occasion Drinks One Occasion questions - How often do you have six or more drinks on Have Six or More Drinks
one occasion?
page 83 of 1925
ADTNQRS (Administration Technique Response)
NCI Code: C132311, Codelist extensible: Yes
C132311 ADTNQRS
Code Value
C85996 HEAF A multiple puncture tuberculin skin test in which a Heaf Heaf Tuberculin Skin Test
gun (device containing 6 needles arranged in a circular
pattern) is dipped into tuberculin purified protein
derivative and pushed into the skin of the flexor surface
of the left forearm. (NCI)
C85997 MANTOUX A single puncture tuberculin skin test in which a standard Mantoux Tuberculin Skin
dose of 5 Tuberculin units of purified protein derivative is Test
injected under the skin of the inner surface of the
forearm.
C85998 TINE A multiple puncture tuberculin skin test in which Tine Tuberculin Skin Test
tuberculin antigen (either purified protein derivative or
old) is pushed into the skin via a device containing 4-6
needles that are coated in tuberculin antigen. (NCI)
page 84 of 1925
AESEV (Severity/Intensity Scale for Adverse Events)
C66769 AESEV
Code Value
C41338 MILD 1;Grade 1 A type of adverse event that is usually transient and may Mild Adverse Event
require only minimal treatment or therapeutic
intervention. The event does not generally interfere with
usual activities of daily living.
C41339 MODERATE 2;Grade 2 A type of adverse event that is usually alleviated with Moderate Adverse Event
additional specific therapeutic intervention. The event
interferes with usual activities of daily living, causing
discomfort but poses no significant or permanent risk of
harm to the research participant.
C41340 SEVERE 3;Grade 3 A type of adverse event that interrupts usual activities of Severe Adverse Event
daily living, or significantly affects clinical status, or may
require intensive therapeutic intervention.
page 85 of 1925
AGEU (Age Unit)
C66781 AGEU
Code Value
C25301 DAYS A unit of measurement of time equal to 24 hours. Day
C25529 HOURS Hours;h;hr A unit of measurement of time equal to 60 minutes. Hour
C29846 MONTHS Month One of the 12 divisions of a year as determined by a Month

calendar. It corresponds to the unit of time of
approximately to one cycle of the moon's phases, about
30 days or 4 weeks. (NCI)
C29844 WEEKS Week Any period of seven consecutive days. (NCI) Week
C29848 YEARS Year The period of time that it takes for Earth to make a Year
complete revolution around the sun, approximately 365
days; a specific one year period. (NCI)
page 86 of 1925
AIMS01TC (Abnormal Involuntary Movement Scale Questionnaire Test Code)
C101805 AIMS01TC
Code Value
C102034 AIMS0101 AIMS01-Muscles of Facial Abnormal Involuntary Movement Scale - Facial and Oral AIMS - Muscles of Facial
Expression Movements, Muscles of facial expression, e.g., Expression
movements of forehead, eyebrows, periorbital area,
cheeks. Include frowning, blinking, grimacing of upper
face.
C102035 AIMS0102 AIMS01-Lips and Perioral Abnormal Involuntary Movement Scale - Facial and Oral AIMS - Lips and Perioral
Area Movements, Lips and perioral area, e.g., puckering, Area
pouting, smacking.
C102036 AIMS0103 AIMS01-Jaw Abnormal Involuntary Movement Scale - Facial and Oral AIMS - Jaw
Movements, Jaw, e.g., biting, clenching, chewing, mouth
opening, lateral movement.
C102037 AIMS0104 AIMS01-Tongue Abnormal Involuntary Movement Scale - Facial and Oral AIMS - Tongue
Movements, Tongue. Rate only increase in movement
both in and out of mouth, not inability to sustain
movement.
C102038 AIMS0105 AIMS01-Upper Abnormal Involuntary Movement Scale - Extremity AIMS - Upper Extremities
Extremities Movements, Upper (arms, wrists, hands, fingers). Include
movements that are choreic (rapid, objectively
purposeless, irregular, spontaneous) or athetoid (slow,
irregular, complex, serpentine). Do not include tremor
(repetitive, regular, rhythmic movements).
C102039 AIMS0106 AIMS01-Lower Abnormal Involuntary Movement Scale - Extremity AIMS - Lower Extremities
Extremities Movements, Lower (legs, knees, ankles, toes), e.g.,
lateral knee movement, foot tapping, heel dropping, foot
squirming, inversion and eversion of foot.
C102040 AIMS0107 AIMS01-Neck, Shoulders, Abnormal Involuntary Movement Scale - Trunk AIMS - Neck, Shoulders,
Hips Movements, Neck, shoulders, hips, e.g., rocking, twisting, Hips
squirming, pelvic gyrations. Include diaphragmatic
movements.
C102041 AIMS0108 AIMS01-Severity of Abnormal Involuntary Movement Scale - Global AIMS - Severity of
Abnormal Movements Judgments, Severity of abnormal movements, based on Abnormal Movements
the highest single score on the above items.
C102042 AIMS0109 AIMS01-Incapacitation Abnormal Involuntary Movement Scale - Global AIMS - Incapacitation
due Abn Movements Judgments, Incapacitation due to abnormal movements. Due to Abnormal
Movements
C102043 AIMS0110 AIMS01-Patient Abnormal Involuntary Movement Scale - Global AIMS - Patient's
Awareness Abn Judgments, Patient's awareness of abnormal movements. Awareness of Abnormal
Movements Movements
C102044 AIMS0111 AIMS01-Current Problems Abnormal Involuntary Movement Scale - Dental Status, AIMS - Current
Teeth/Dentures Current problems with teeth and/or dentures. Teeth/Dentures Problems
C102045 AIMS0112 AIMS01-Patient Usually Abnormal Involuntary Movement Scale - Dental Status, AIMS - Patient Usually
Wear Dentures Does patient usually wear dentures? Wears Dentures
page 87 of 1925
AIMS01TN (Abnormal Involuntary Movement Scale Questionnaire Test Name)
C101806 AIMS01TN
Code Value
C102044 AIMS01-Current Problems AIMS01-Current Problems Abnormal Involuntary Movement Scale - Dental Status, AIMS - Current
Teeth/Dentures Teeth/Dentures Current problems with teeth and/or dentures. Teeth/Dentures Problems
C102042 AIMS01-Incapacitation AIMS01-Incapacitation Abnormal Involuntary Movement Scale - Global AIMS - Incapacitation
due Abn Movements due Abn Movements Judgments, Incapacitation due to abnormal movements. Due to Abnormal
Movements
C102036 AIMS01-Jaw AIMS01-Jaw Abnormal Involuntary Movement Scale - Facial and Oral AIMS - Jaw
Movements, Jaw, e.g., biting, clenching, chewing, mouth
opening, lateral movement.
C102035 AIMS01-Lips and Perioral AIMS01-Lips and Perioral Abnormal Involuntary Movement Scale - Facial and Oral AIMS - Lips and Perioral
Area Area Movements, Lips and perioral area, e.g., puckering, Area
pouting, smacking.
C102039 AIMS01-Lower AIMS01-Lower Abnormal Involuntary Movement Scale - Extremity AIMS - Lower Extremities
Extremities Extremities Movements, Lower (legs, knees, ankles, toes), e.g.,
lateral knee movement, foot tapping, heel dropping, foot
squirming, inversion and eversion of foot.
C102034 AIMS01-Muscles of Facial AIMS01-Muscles of Facial Abnormal Involuntary Movement Scale - Facial and Oral AIMS - Muscles of Facial
Expression Expression Movements, Muscles of facial expression, e.g., Expression
movements of forehead, eyebrows, periorbital area,
cheeks. Include frowning, blinking, grimacing of upper
face.
C102040 AIMS01-Neck, Shoulders, AIMS01-Neck, Shoulders, Abnormal Involuntary Movement Scale - Trunk AIMS - Neck, Shoulders,
Hips Hips Movements, Neck, shoulders, hips, e.g., rocking, twisting, Hips
squirming, pelvic gyrations. Include diaphragmatic
movements.
C102043 AIMS01-Patient AIMS01-Patient Abnormal Involuntary Movement Scale - Global AIMS - Patient's
Awareness Abn Awareness Abn Judgments, Patient's awareness of abnormal movements. Awareness of Abnormal
Movements Movements Movements
C102045 AIMS01-Patient Usually AIMS01-Patient Usually Abnormal Involuntary Movement Scale - Dental Status, AIMS - Patient Usually
Wear Dentures Wear Dentures Does patient usually wear dentures? Wears Dentures
C102041 AIMS01-Severity of AIMS01-Severity of Abnormal Involuntary Movement Scale - Global AIMS - Severity of
Abnormal Movements Abnormal Movements Judgments, Severity of abnormal movements, based on Abnormal Movements
the highest single score on the above items.
C102037 AIMS01-Tongue AIMS01-Tongue Abnormal Involuntary Movement Scale - Facial and Oral AIMS - Tongue
Movements, Tongue. Rate only increase in movement
both in and out of mouth, not inability to sustain
movement.
C102038 AIMS01-Upper AIMS01-Upper Abnormal Involuntary Movement Scale - Extremity AIMS - Upper Extremities
Extremities Extremities Movements, Upper (arms, wrists, hands, fingers). Include
movements that are choreic (rapid, objectively
purposeless, irregular, spontaneous) or athetoid (slow,
irregular, complex, serpentine). Do not include tremor
(repetitive, regular, rhythmic movements).
page 88 of 1925
AJCC1TC (AJCC TNM Staging System 7th Edition Clinical Classification Test Code)
C141655 AJCC1TC
Code Value
C141696 AJCC101 AJCC1-Primary Tumor (T) AJCC TNM Staging System 7th Edition - Primary tumor AJCC v7 - Primary Tumor
(T). (T)
C141697 AJCC102 AJCC1-Regional Lymph AJCC TNM Staging System 7th Edition - Regional lymph AJCC v7 - Regional
Nodes (N) nodes (N). Lymph Nodes (N)
C141698 AJCC103 AJCC1-Distant Metastasis AJCC TNM Staging System 7th Edition - Distant AJCC v7 - Distant
(M) metastasis (M). Metastasis (M)
C141699 AJCC104 AJCC1-Anatomic Stage AJCC TNM Staging System 7th Edition - Anatomic stage. AJCC v7 - Anatomic Stage
page 89 of 1925
AJCC1TN (AJCC TNM Staging System 7th Edition Clinical Classification Test Name)
C141654 AJCC1TN
Code Value
C141699 AJCC1-Anatomic Stage AJCC1-Anatomic Stage AJCC TNM Staging System 7th Edition - Anatomic stage. AJCC v7 - Anatomic Stage
C141698 AJCC1-Distant Metastasis AJCC1-Distant Metastasis AJCC TNM Staging System 7th Edition - Distant AJCC v7 - Distant
(M) (M) metastasis (M). Metastasis (M)
C141696 AJCC1-Primary Tumor (T) AJCC1-Primary Tumor (T) AJCC TNM Staging System 7th Edition - Primary tumor AJCC v7 - Primary Tumor
(T). (T)
C141697 AJCC1-Regional Lymph AJCC1-Regional Lymph AJCC TNM Staging System 7th Edition - Regional lymph AJCC v7 - Regional
Nodes (N) Nodes (N) nodes (N). Lymph Nodes (N)
page 90 of 1925
AJCCGRD (AJCC Tumor Grade Response)
C135012 AJCCGRD
Code Value
C28077 GRADE 1 G1 A morphologic qualifier by the American Joint Cancer Grade 1

Committee (AJCC) indicating that a cancerous lesion is
well differentiated. (American Joint Committee on Cancer.
AJCC Cancer Staging Manual. 7th ed. New York, NY:
Springer; 2010.)

moderately differentiated. (American Joint Committee on
Cancer. AJCC Cancer Staging Manual. 7th ed. New York,
NY: Springer; 2010.)

poorly differentiated. (American Joint Committee on
Cancer. AJCC Cancer Staging Manual. 7th ed. New York,
NY: Springer; 2010.)

undifferentiated. (American Joint Committee on Cancer.
AJCC Cancer Staging Manual. 7th ed. New York, NY:
Springer; 2010.)
C113730 GRADE X GX A morphologic qualifier by the American Joint Cancer Grade X

Committee (AJCC) indicating that the grade of a
cancerous lesion cannot be assessed. (American Joint
Committee on Cancer. AJCC Cancer Staging Manual. 7th
ed. New York, NY: Springer; 2010.)
page 91 of 1925
APCH1TC (Acute Physiology and Chronic Health Evaluation II Clinical Classification Test Code)
C120985 APCH1TC
Code Value
C121096 APCH101 APCH1-Temperature - Acute Physiology and Chronic Health Evaluation II - APACHE II -
Rectal Temperature - rectal (degree C). Temperature, Rectal
C121097 APCH102 APCH1-Mean Arterial Acute Physiology and Chronic Health Evaluation II - Mean APACHE II - Mean Arterial
Pressure arterial pressure - mmHg. Pressure
C121098 APCH103 APCH1-Heart Rate Acute Physiology and Chronic Health Evaluation II - Heart APACHE II - Heart Rate
rate (ventricular response).
C121099 APCH104 APCH1-Respiratory Rate Acute Physiology and Chronic Health Evaluation II - APACHE II - Respiratory
Respiratory rate (non-ventilated or ventilated). Rate
C121100 APCH105A APCH1-Oxygenation: A- Acute Physiology and Chronic Health Evaluation II - APACHE II - Oxygenation,
aDO2 Oxygenation (mmHg): FIO2 greater than or equal to 0.5 A-aDO2
record A-aDO2.
C121101 APCH105B APCH1-Oxygenation: Acute Physiology and Chronic Health Evaluation II - APACHE II - Oxygenation,
PaO2 Oxygenation (mmHg): FIO2 less than 0.5 record only PaO2
PaO2.
C121102 APCH106A APCH1-Arterial pH Acute Physiology and Chronic Health Evaluation II - APACHE II - Arterial pH
Arterial pH (preferred).
C121103 APCH106B APCH1-Serum HCO3 Acute Physiology and Chronic Health Evaluation II - APACHE II - Serum HCO3
Serum HCO3 (venous mMol/L) (Not preferred, use if no
ABGs).
C121104 APCH107 APCH1-Serum Sodium Acute Physiology and Chronic Health Evaluation II - APACHE II - Serum
Serum sodium (mMol/L). Sodium
C121105 APCH108 APCH1-Serum Potassium Acute Physiology and Chronic Health Evaluation II - APACHE II - Serum
Serum potassium (mMol/L). Potassium
C121106 APCH109 APCH1-Serum Creatinine Acute Physiology and Chronic Health Evaluation II - APACHE II - Serum
Serum creatinine (mg/100 mL) (double point score for Creatinine
acute renal failure).
C121107 APCH110 APCH1-Hematocrit Acute Physiology and Chronic Health Evaluation II - APACHE II - Hematocrit
Hematocrit (%).
C121108 APCH111 APCH1-White Blood Count Acute Physiology and Chronic Health Evaluation II - White APACHE II - White Blood
blood count (total/mm3) (in 1,000s). Count
C121109 APCH112 APCH1-15 Minus Glasgow Acute Physiology and Chronic Health Evaluation II - APACHE II - 15 Minus
Coma Score Glasgow coma score: Score equals 15 minus actual GCS. Glasgow Coma Score
C121110 APCH113 APCH1-A: Total Acute Acute Physiology and Chronic Health Evaluation II - A: APACHE II - A, Total
Physiology Score Total acute physiology score. Acute Physiology Score
C121111 APCH114 APCH1-B: Age Points Acute Physiology and Chronic Health Evaluation II - B: APACHE II - B, Age Points
Age points (years).
C121112 APCH115 APCH1-C: Chronic Health Acute Physiology and Chronic Health Evaluation II - C: APACHE II - C, Chronic
Points Chronic health points. Health Points
C121113 APCH116 APCH1-Total APACHE II Acute Physiology and Chronic Health Evaluation II - Total APACHE II - Total
Score APACHE II score. APACHE II Score
page 92 of 1925
APCH1TN (Acute Physiology and Chronic Health Evaluation II Clinical Classification Test Name)
C120984 APCH1TN
Code Value
C121109 APCH1-15 Minus Glasgow APCH1-15 Minus Glasgow Acute Physiology and Chronic Health Evaluation II - APACHE II - 15 Minus
Coma Score Coma Score Glasgow coma score: Score equals 15 minus actual GCS. Glasgow Coma Score
C121110 APCH1-A: Total Acute APCH1-A: Total Acute Acute Physiology and Chronic Health Evaluation II - A: APACHE II - A, Total
Physiology Score Physiology Score Total acute physiology score. Acute Physiology Score
C121102 APCH1-Arterial pH APCH1-Arterial pH Acute Physiology and Chronic Health Evaluation II - APACHE II - Arterial pH
Arterial pH (preferred).
C121111 APCH1-B: Age Points APCH1-B: Age Points Acute Physiology and Chronic Health Evaluation II - B: APACHE II - B, Age Points
Age points (years).
C121112 APCH1-C: Chronic Health APCH1-C: Chronic Health Acute Physiology and Chronic Health Evaluation II - C: APACHE II - C, Chronic
Points Points Chronic health points. Health Points
C121098 APCH1-Heart Rate APCH1-Heart Rate Acute Physiology and Chronic Health Evaluation II - Heart APACHE II - Heart Rate
rate (ventricular response).
C121107 APCH1-Hematocrit APCH1-Hematocrit Acute Physiology and Chronic Health Evaluation II - APACHE II - Hematocrit
Hematocrit (%).
C121097 APCH1-Mean Arterial APCH1-Mean Arterial Acute Physiology and Chronic Health Evaluation II - Mean APACHE II - Mean Arterial
Pressure Pressure arterial pressure - mmHg. Pressure
C121100 APCH1-Oxygenation: A- APCH1-Oxygenation: A- Acute Physiology and Chronic Health Evaluation II - APACHE II - Oxygenation,
aDO2 aDO2 Oxygenation (mmHg): FIO2 greater than or equal to 0.5 A-aDO2
record A-aDO2.
C121101 APCH1-Oxygenation: APCH1-Oxygenation: Acute Physiology and Chronic Health Evaluation II - APACHE II - Oxygenation,
PaO2 PaO2 Oxygenation (mmHg): FIO2 less than 0.5 record only PaO2
PaO2.
C121099 APCH1-Respiratory Rate APCH1-Respiratory Rate Acute Physiology and Chronic Health Evaluation II - APACHE II - Respiratory
Respiratory rate (non-ventilated or ventilated). Rate
C121106 APCH1-Serum Creatinine APCH1-Serum Creatinine Acute Physiology and Chronic Health Evaluation II - APACHE II - Serum
Serum creatinine (mg/100 mL) (double point score for Creatinine
acute renal failure).
C121103 APCH1-Serum HCO3 APCH1-Serum HCO3 Acute Physiology and Chronic Health Evaluation II - APACHE II - Serum HCO3
Serum HCO3 (venous mMol/L) (Not preferred, use if no
ABGs).
C121105 APCH1-Serum Potassium APCH1-Serum Potassium Acute Physiology and Chronic Health Evaluation II - APACHE II - Serum
Serum potassium (mMol/L). Potassium
C121104 APCH1-Serum Sodium APCH1-Serum Sodium Acute Physiology and Chronic Health Evaluation II - APACHE II - Serum
Serum sodium (mMol/L). Sodium
C121096 APCH1-Temperature - APCH1-Temperature - Acute Physiology and Chronic Health Evaluation II - APACHE II -
Rectal Rectal Temperature - rectal (degree C). Temperature, Rectal
C121113 APCH1-Total APACHE II APCH1-Total APACHE II Acute Physiology and Chronic Health Evaluation II - Total APACHE II - Total
Score Score APACHE II score. APACHE II Score
C121108 APCH1-White Blood Count APCH1-White Blood Count Acute Physiology and Chronic Health Evaluation II - White APACHE II - White Blood
blood count (total/mm3) (in 1,000s). Count
page 93 of 1925
AQ01TC (Airway Questionnaire 20 Questionnaire Test Code)
C112435 AQ01TC
Code Value
C112529 AQ0101 AQ01-Cough Often Airway Questionnaire 20 - Do you cough often during the AQ20 - Cough Often
During Day day? During the Day
C112530 AQ0102 AQ01-Feel Restless Due Airway Questionnaire 20 - Does your chest trouble often AQ20 - Chest Trouble
to Chest Trouble make you feel restless? Make You Feel Restless
C112531 AQ0103 AQ01-Gardening Make Airway Questionnaire 20 - Does gardening make you AQ20 - Gardening Make
You Breathless breathless? You Breathless
C112532 AQ0104 AQ01-Chest Upset at Airway Questionnaire 20 - Do you worry when going to a AQ20 - Worry When
Friend House friend's house that there might be something there that Going to Friend House
will upset your chest? Something Will Upset
Your Chest
C112533 AQ0105 AQ01-Chest Prob Airway Questionnaire 20 - Do you get chest problems AQ20 - Get Chest
Smell/Fume/Smoke/Perfu when you come into contact with strong smells, exhaust Problems When Contact
me fumes, cigarette smoke, perfume etc? With Strong Smells
C112534 AQ0106 AQ01-Partner Upset by Airway Questionnaire 20 - Does your partner find your AQ20 - Partner Find Your
Your Chest Trouble chest trouble upsetting? Chest Trouble Upsetting
C112535 AQ0107 AQ01-Breathless When Airway Questionnaire 20 - Do you feel breathless when AQ20 - Feel Breathless
Trying to Sleep trying to sleep? When Trying to Sleep
C112536 AQ0108 AQ01-Long Term Effects Airway Questionnaire 20 - Do you worry about the long AQ20 - Worry About Long
of Drugs term effects of the drugs you take for your chest trouble? Term Effects of Drugs for
Chest Trouble
C112537 AQ0109 AQ01-Emotional Upset Airway Questionnaire 20 - Does getting emotionally upset AQ20 - Getting
Worse Chest Trouble make your chest trouble worse? Emotionally Upset Make
Chest Trouble Worse
C112538 AQ0110 AQ01-Difficulty Getting Airway Questionnaire 20 - Are there times when you have AQ20 - Difficulty Getting
Around the House difficulty getting around the house because of your chest Around the House
trouble? Because of Chest Trouble
C112539 AQ0111 AQ01-Breathless Carry Airway Questionnaire 20 - Does your chest problem make AQ20 - Chest Problem
out Work Activity you breathless when you do things at work? (paid Make You Breathless at
employment). Work
C112540 AQ0112 AQ01-Breathless Walking Airway Questionnaire 20 - Does walking upstairs make AQ20 - Walking Upstairs
Upstairs you breathless? Make You Breathless
C112541 AQ0113 AQ01-Get Breathless Airway Questionnaire 20 - Do you get breathless doing AQ20 - Get Breathless
Doing Housework housework? Doing Housework
C112542 AQ0114 AQ01-Go Home Sooner Airway Questionnaire 20 - Does your chest trouble make AQ20 - Chest Trouble
Than Others you go home sooner than others after a night out? Make You Go Home
Sooner Than Others
C112543 AQ0115 AQ01-Breathlessness Airway Questionnaire 20 - Do you suffer from AQ20 - Suffer From
When Laugh breathlessness when you laugh? Breathlessness When
Laugh
C112544 AQ0116 AQ01-Impatient Due to Airway Questionnaire 20 - Does your chest trouble often AQ20 - Chest Trouble
Chest Trouble make you feel impatient? Make You Feel Impatient
C112545 AQ0117 AQ01-Full Life Limited by Airway Questionnaire 20 - Do you think the fullness of AQ20 - Fullness of Life is
Chest Trouble your life is limited by your chest trouble? Limited by Chest Trouble
C112546 AQ0118 AQ01-Drained After a Airway Questionnaire 20 - Do you feel drained after a AQ20 - Feel Drained After
Cold cold because of your chest trouble? a Cold Because of Chest
Trouble
C112547 AQ0119 AQ01-Feeling of Chest Airway Questionnaire 20 - Do you have a feeling of chest AQ20 - Feeling of Chest
Heaviness heaviness? Heaviness
C112548 AQ0120 AQ01-Worry About Chest Airway Questionnaire 20 - Do you worry a lot about your AQ20 - Worry a Lot About
Trouble chest trouble? Chest Trouble
page 94 of 1925
AQ01TN (Airway Questionnaire 20 Questionnaire Test Name)
C112434 AQ01TN
Code Value
C112539 AQ01-Breathless Carry AQ01-Breathless Carry Airway Questionnaire 20 - Does your chest problem make AQ20 - Chest Problem
out Work Activity out Work Activity you breathless when you do things at work? (paid Make You Breathless at
employment). Work
C112540 AQ01-Breathless Walking AQ01-Breathless Walking Airway Questionnaire 20 - Does walking upstairs make AQ20 - Walking Upstairs
Upstairs Upstairs you breathless? Make You Breathless
C112535 AQ01-Breathless When AQ01-Breathless When Airway Questionnaire 20 - Do you feel breathless when AQ20 - Feel Breathless
Trying to Sleep Trying to Sleep trying to sleep? When Trying to Sleep
C112543 AQ01-Breathlessness AQ01-Breathlessness Airway Questionnaire 20 - Do you suffer from AQ20 - Suffer From
When Laugh When Laugh breathlessness when you laugh? Breathlessness When
Laugh
C112533 AQ01-Chest Prob AQ01-Chest Prob Airway Questionnaire 20 - Do you get chest problems AQ20 - Get Chest
Smell/Fume/Smoke/Perfu Smell/Fume/Smoke/Perfu when you come into contact with strong smells, exhaust Problems When Contact
me me fumes, cigarette smoke, perfume etc? With Strong Smells
C112532 AQ01-Chest Upset at AQ01-Chest Upset at Airway Questionnaire 20 - Do you worry when going to a AQ20 - Worry When
Friend House Friend House friend's house that there might be something there that Going to Friend House
will upset your chest? Something Will Upset
Your Chest
C112529 AQ01-Cough Often AQ01-Cough Often Airway Questionnaire 20 - Do you cough often during the AQ20 - Cough Often
During Day During Day day? During the Day
C112538 AQ01-Difficulty Getting AQ01-Difficulty Getting Airway Questionnaire 20 - Are there times when you have AQ20 - Difficulty Getting
Around the House Around the House difficulty getting around the house because of your chest Around the House
trouble? Because of Chest Trouble
C112546 AQ01-Drained After a AQ01-Drained After a Airway Questionnaire 20 - Do you feel drained after a AQ20 - Feel Drained After
Cold Cold cold because of your chest trouble? a Cold Because of Chest
Trouble
C112537 AQ01-Emotional Upset AQ01-Emotional Upset Airway Questionnaire 20 - Does getting emotionally upset AQ20 - Getting
Worse Chest Trouble Worse Chest Trouble make your chest trouble worse? Emotionally Upset Make
Chest Trouble Worse
C112530 AQ01-Feel Restless Due AQ01-Feel Restless Due Airway Questionnaire 20 - Does your chest trouble often AQ20 - Chest Trouble
to Chest Trouble to Chest Trouble make you feel restless? Make You Feel Restless
C112547 AQ01-Feeling of Chest AQ01-Feeling of Chest Airway Questionnaire 20 - Do you have a feeling of chest AQ20 - Feeling of Chest
Heaviness Heaviness heaviness? Heaviness
C112545 AQ01-Full Life Limited by AQ01-Full Life Limited by Airway Questionnaire 20 - Do you think the fullness of AQ20 - Fullness of Life is
Chest Trouble Chest Trouble your life is limited by your chest trouble? Limited by Chest Trouble
C112531 AQ01-Gardening Make AQ01-Gardening Make Airway Questionnaire 20 - Does gardening make you AQ20 - Gardening Make
You Breathless You Breathless breathless? You Breathless
C112541 AQ01-Get Breathless AQ01-Get Breathless Airway Questionnaire 20 - Do you get breathless doing AQ20 - Get Breathless
Doing Housework Doing Housework housework? Doing Housework
C112542 AQ01-Go Home Sooner AQ01-Go Home Sooner Airway Questionnaire 20 - Does your chest trouble make AQ20 - Chest Trouble
Than Others Than Others you go home sooner than others after a night out? Make You Go Home
Sooner Than Others
C112544 AQ01-Impatient Due to AQ01-Impatient Due to Airway Questionnaire 20 - Does your chest trouble often AQ20 - Chest Trouble
Chest Trouble Chest Trouble make you feel impatient? Make You Feel Impatient
C112536 AQ01-Long Term Effects AQ01-Long Term Effects Airway Questionnaire 20 - Do you worry about the long AQ20 - Worry About Long
of Drugs of Drugs term effects of the drugs you take for your chest trouble? Term Effects of Drugs for
Chest Trouble
C112534 AQ01-Partner Upset by AQ01-Partner Upset by Airway Questionnaire 20 - Does your partner find your AQ20 - Partner Find Your
Your Chest Trouble Your Chest Trouble chest trouble upsetting? Chest Trouble Upsetting
C112548 AQ01-Worry About Chest AQ01-Worry About Chest Airway Questionnaire 20 - Do you worry a lot about your AQ20 - Worry a Lot About
Trouble Trouble chest trouble? Chest Trouble
page 95 of 1925
ARMNULRS (Arm Null Reason)
C142179 ARMNULRS
Code Value
C142238 ASSIGNED, NOT The subject, who met eligibility criteria, was assigned to Subject Assigned to Arm
TREATED an arm but was not treated. (NCI) But Not Treated
C142239 NOT ASSIGNED The subject, who met eligibility criteria, was not assigned Subject Not Assigned to
to an arm and was not treated. (NCI) Arm
C49628 SCREEN FAILURE The potential subject who does not meet one or more Trial Screen Failure
criteria required for participation in a trial.
C142240 UNPLANNED TREATMENT The subject, who met eligibility criteria, was assigned to Subject Received
an arm but received treatment not associated with any of Unplanned Treatment
the planned arms.
page 96 of 1925
ASCVD1TC (Atherosclerotic Cardiovascular Disease 10-Year Risk Estimator Clinical Classification Test
Code)
C124666 ASCVD1TC
Code Value
C124720 ASCVD101 ASCVD1-ASCVD 10-Year Atherosclerotic Cardiovascular Disease 10-Year Risk ASCVD 10-Year Risk
Risk Score Estimator - Risk score. Estimator - Risk Score
page 97 of 1925
ASCVD1TN (Atherosclerotic Cardiovascular Disease 10-Year Risk Estimator Clinical Classification Test
Name)
C124665 ASCVD1TN
Code Value
C124720 ASCVD1-ASCVD 10-Year ASCVD1-ASCVD 10-Year Atherosclerotic Cardiovascular Disease 10-Year Risk ASCVD 10-Year Risk
Risk Score Risk Score Estimator - Risk score. Estimator - Risk Score
page 98 of 1925
ASEX01TC (Arizona Sexual Experiences Scale - Female Questionnaire Test Code)
C125741 ASEX01TC
Code Value
C125763 ASEX0101 ASEX01-Sex Drive Arizona Sexual Experiences Scale Female - How strong is ASEX-Female Version -
your sex drive? Sex Drive
C125764 ASEX0102 ASEX01-Sexually Aroused Arizona Sexual Experiences Scale Female - How easily are ASEX-Female Version -
you sexually aroused (turned on)? Sexually Aroused
C125765 ASEX0103 ASEX01-Vagina Become Arizona Sexual Experiences Scale Female - How easily ASEX-Female Version -
Moist does your vagina become moist or wet during sex? Vagina Become Moist
C125766 ASEX0104 ASEX01-Reach Orgasm Arizona Sexual Experiences Scale Female - How easily ASEX-Female Version -
can you reach an orgasm? Reach Orgasm
C125767 ASEX0105 ASEX01-Orgasms Arizona Sexual Experiences Scale Female - Are your ASEX-Female Version -
Satisfying orgasms satisfying? Orgasms Satisfying
C129254 ASEX0106 ASEX01-Comments Arizona Sexual Experiences Scale Female - Comments. ASEX-Female Version -
Comments
page 99 of 1925
ASEX01TN (Arizona Sexual Experiences Scale - Female Questionnaire Test Name)
C125740 ASEX01TN
Code Value
C129254 ASEX01-Comments ASEX01-Comments Arizona Sexual Experiences Scale Female - Comments. ASEX-Female Version -
Comments
C125767 ASEX01-Orgasms ASEX01-Orgasms Arizona Sexual Experiences Scale Female - Are your ASEX-Female Version -
Satisfying Satisfying orgasms satisfying? Orgasms Satisfying
C125766 ASEX01-Reach Orgasm ASEX01-Reach Orgasm Arizona Sexual Experiences Scale Female - How easily ASEX-Female Version -
can you reach an orgasm? Reach Orgasm
C125763 ASEX01-Sex Drive ASEX01-Sex Drive Arizona Sexual Experiences Scale Female - How strong is ASEX-Female Version -
your sex drive? Sex Drive
C125764 ASEX01-Sexually Aroused ASEX01-Sexually Aroused Arizona Sexual Experiences Scale Female - How easily are ASEX-Female Version -
C125765 ASEX01-Vagina Become ASEX01-Vagina Become Arizona Sexual Experiences Scale Female - How easily ASEX-Female Version -
Moist Moist does your vagina become moist or wet during sex? Vagina Become Moist
page 100 of 1925

ASEX02TC (Arizona Sexual Experiences Scale - Male Questionnaire Test Code)
C125743 ASEX02TC
Code Value
C125768 ASEX0201 ASEX02-Sex Drive Arizona Sexual Experiences Scale Male - How strong is ASEX-Male Version - Sex
your sex drive? Drive
C125769 ASEX0202 ASEX02-Sexually Aroused Arizona Sexual Experiences Scale Male - How easily are ASEX-Male Version -
C125770 ASEX0203 ASEX02-Keep Erection Arizona Sexual Experiences Scale Male - Can you easily ASEX-Male Version -
get and keep an erection? Keep Erection
C125771 ASEX0204 ASEX02-Reach Orgasm Arizona Sexual Experiences Scale Male - How easily can ASEX-Male Version -
you reach an orgasm? Reach Orgasm
C125772 ASEX0205 ASEX02-Orgasms Arizona Sexual Experiences Scale Male - Are your ASEX-Male Version -
Satisfying orgasms satisfying? Orgasms Satisfying
C129256 ASEX0206 ASEX02-Comments Arizona Sexual Experiences Scale Male - Comments. ASEX-Male Version -
Comments
page 101 of 1925

ASEX02TN (Arizona Sexual Experiences Scale - Male Questionnaire Test Name)
C125742 ASEX02TN
Code Value
C129256 ASEX02-Comments ASEX02-Comments Arizona Sexual Experiences Scale Male - Comments. ASEX-Male Version -
Comments
C125770 ASEX02-Keep Erection ASEX02-Keep Erection Arizona Sexual Experiences Scale Male - Can you easily ASEX-Male Version -
get and keep an erection? Keep Erection
C125772 ASEX02-Orgasms ASEX02-Orgasms Arizona Sexual Experiences Scale Male - Are your ASEX-Male Version -
Satisfying Satisfying orgasms satisfying? Orgasms Satisfying
C125771 ASEX02-Reach Orgasm ASEX02-Reach Orgasm Arizona Sexual Experiences Scale Male - How easily can ASEX-Male Version -
you reach an orgasm? Reach Orgasm
C125768 ASEX02-Sex Drive ASEX02-Sex Drive Arizona Sexual Experiences Scale Male - How strong is ASEX-Male Version - Sex
your sex drive? Drive
C125769 ASEX02-Sexually Aroused ASEX02-Sexually Aroused Arizona Sexual Experiences Scale Male - How easily are ASEX-Male Version -
page 102 of 1925

ASFATS (Asthma Findings About Test Name)
C132312 ASFATS
Code Value
C127786 Occurrence Indicator Occurrence Indicator An indication as to whether something has happened, Occurrence Indicator
such as an event or incident.
page 103 of 1925

ASFATSCD (Asthma Findings About Test Code)
C132313 ASFATSCD
Code Value
C127786 OCCUR Occurrence Indicator An indication as to whether something has happened, Occurrence Indicator
page 104 of 1925

ASSG01TC (ASSIGN Cardiovascular Disease 10-Year Risk Score Clinical Classification Test Code)
C124668 ASSG01TC
Code Value
C124721 ASSG0101 ASSG01-ASSIGN Score ASSIGN Cardiovascular Disease 10-Year Risk Score - ASSIGN Score - Risk
ASSIGN score. Score
page 105 of 1925

ASSG01TN (ASSIGN Cardiovascular Disease 10-Year Risk Score Clinical Classification Test Name)
C124667 ASSG01TN
Code Value
C124721 ASSG01-ASSIGN Score ASSG01-ASSIGN Score ASSIGN Cardiovascular Disease 10-Year Risk Score - ASSIGN Score - Risk
ASSIGN score. Score
page 106 of 1925

ATLAS1TC (ATLAS Clinical Classification Test Code)
C147538 ATLAS1TC
Code Value
C147843 ATLAS101 ATLAS1-Age Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Age
serum albumin, and serum creatinine as a measure of
renal function - Age.
C147844 ATLAS102 ATLAS1-Treatment With Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Treatment With
Antibiotics serum albumin, and serum creatinine as a measure of Antibiotics
renal function - Treatment with systemic antibiotics
during CDI therapy (>= 1 day).
C147845 ATLAS103 ATLAS1-Leukocyte Count Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Leukocyte Count
renal function - Leukocyte count (total).
C147846 ATLAS104 ATLAS1-Albumin Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Albumin
renal function - Albumin (serum).
C147847 ATLAS105 ATLAS1-Serum Creatinine Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Serum Creatinine
renal function - Serum creatinine (as a measure of renal
function).
C147848 ATLAS106 ATLAS1-Score Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Score
renal function - Score.
page 107 of 1925

ATLAS1TN (ATLAS Clinical Classification Test Name)
C147537 ATLAS1TN
Code Value
C147843 ATLAS1-Age ATLAS1-Age Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Age
renal function - Age.
C147846 ATLAS1-Albumin ATLAS1-Albumin Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Albumin
renal function - Albumin (serum).
C147845 ATLAS1-Leukocyte Count ATLAS1-Leukocyte Count Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Leukocyte Count
renal function - Leukocyte count (total).
C147848 ATLAS1-Score ATLAS1-Score Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Score
renal function - Score.
C147847 ATLAS1-Serum Creatinine ATLAS1-Serum Creatinine Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Serum Creatinine
renal function - Serum creatinine (as a measure of renal
function).
C147844 ATLAS1-Treatment With ATLAS1-Treatment With Age, treatment with systemic antibiotics, leukocyte count, ATLAS - Treatment With
Antibiotics Antibiotics serum albumin, and serum creatinine as a measure of Antibiotics
renal function - Treatment with systemic antibiotics
during CDI therapy (>= 1 day).
page 108 of 1925

AVL01TC (ADNI Auditory Verbal Learning Functional Test Test Code)
C101807 AVL01TC
Code Value
C101896 AVL01001 AVL01-List A Recall 1 Auditory Verbal Learning Test Version A - List A, Recall 1, ADNI AVLT - List A Recall
Word 1 Word 1. 1 Word 1
C101911 AVL01016 AVL01-List A Recall 1 Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A Recall
Total words recalled from List A, first attempt. 1 Total
C101912 AVL01017 AVL01-List A Intrusions 1 Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A
intrusions while recalling List A, first attempt. Intrusions 1
page 109 of 1925

C101807 AVL01TC
Code Value
Total words recalled from List A, second attempt. 2 Total
intrusions while recalling List A, second attempt. Intrusions 2
Total words recalled from List A, third attempt. 3 Total
intrusions while recalling List A, third attempt. Intrusions 3
page 110 of 1925

C101807 AVL01TC
Code Value
Total words recalled from List A, fourth attempt. 4 Total
intrusions while recalling List A, fourth attempt. Intrusions 4
page 111 of 1925

C101807 AVL01TC
Code Value
Total words recalled from List A, fifth attempt. 5 Total
intrusions while recalling List A, fifth attempt. Intrusions 5
C101981 AVL01086 AVL01-List A Recall 6 Auditory Verbal Learning Test Version A - List A, Recall 6 ADNI AVLT - List A Recall
(After B) Word 1 (after B Recall), Word 1. 6 (After B) Word 1
(After B) Total words recalled from List A, sixth attempt (after List B 6 (After B) Total
recall).
intrusions while recalling List A, sixth attempt (after List B Intrusions 6
recall).
C101998 AVL01103 AVL01-List B Recall Word Auditory Verbal Learning Test Version A - List B, Word 1. ADNI AVLT - List B Recall
1 Word 1
2 Word 2
3 Word 3
4 Word 4
5 Word 5
page 112 of 1925

C101807 AVL01TC
Code Value
6 Word 6
7 Word 7
8 Word 8
9 Word 9
10 Word 10
11 Word 11
12 Word 12
13 Word 13
14 Word 14
15 Word 15
C102013 AVL01118 AVL01-List B Recall Total Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List B Recall
words recalled from List B. Total
C102014 AVL01119 AVL01-List B Intrusions Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List B
intrusions while recalling List B. Intrusions
C102015 AVL01120 AVL01-List A 30 Min Auditory Verbal Learning Test Version A - List A, 30 ADNI AVLT - List A 30 Min
Delay Recall Word 1 Minute Delay Recall, Word 1. Delay Recall Word 1
page 113 of 1925

C101807 AVL01TC
Code Value
C102030 AVL01135 AVL01-List A 30 Min Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A 30 Min
Delay Recall Total words recalled from List A, 30 Minute Delay recall. Delay Recall Total
C102031 AVL01136 AVL01-List A 30 Min Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A 30 Min
Delay Intrusions intrusions while recalling List A, 30 Minute Delay. Delay Intrusions
C102032 AVL01137 AVL01-List A Recognition Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A
Total words correct on recognition test. Recognition Total
C102033 AVL01138 AVL01-List A Recognition Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A
Intrusions intrusions on recognition test. Recognition Intrusions
page 114 of 1925

AVL01TN (ADNI Auditory Verbal Learning Functional Test Test Name)
C101808 AVL01TN
Code Value
C102031 AVL01-List A 30 Min AVL01-List A 30 Min Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A 30 Min
Delay Intrusions Delay Intrusions intrusions while recalling List A, 30 Minute Delay. Delay Intrusions
C102030 AVL01-List A 30 Min AVL01-List A 30 Min Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A 30 Min
Delay Recall Total Delay Recall Total words recalled from List A, 30 Minute Delay recall. Delay Recall Total
C102015 AVL01-List A 30 Min AVL01-List A 30 Min Auditory Verbal Learning Test Version A - List A, 30 ADNI AVLT - List A 30 Min
Delay Recall Word 1 Delay Recall Word 1 Minute Delay Recall, Word 1. Delay Recall Word 1
C101912 AVL01-List A Intrusions 1 AVL01-List A Intrusions 1 Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A
intrusions while recalling List A, first attempt. Intrusions 1
intrusions while recalling List A, second attempt. Intrusions 2
intrusions while recalling List A, third attempt. Intrusions 3
intrusions while recalling List A, fourth attempt. Intrusions 4
intrusions while recalling List A, fifth attempt. Intrusions 5
intrusions while recalling List A, sixth attempt (after List B Intrusions 6
recall).
C101911 AVL01-List A Recall 1 AVL01-List A Recall 1 Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A Recall
Total Total words recalled from List A, first attempt. 1 Total
C101896 AVL01-List A Recall 1 AVL01-List A Recall 1 Auditory Verbal Learning Test Version A - List A, Recall 1, ADNI AVLT - List A Recall
Word 1 Word 1 Word 1. 1 Word 1
page 115 of 1925

C101808 AVL01TN
Code Value
Total Total words recalled from List A, second attempt. 2 Total
page 116 of 1925

C101808 AVL01TN
Code Value
Total Total words recalled from List A, third attempt. 3 Total
Total Total words recalled from List A, fourth attempt. 4 Total
page 117 of 1925

C101808 AVL01TN
Code Value
Total Total words recalled from List A, fifth attempt. 5 Total
(After B) Total (After B) Total words recalled from List A, sixth attempt (after List B 6 (After B) Total
recall).
C101981 AVL01-List A Recall 6 AVL01-List A Recall 6 Auditory Verbal Learning Test Version A - List A, Recall 6 ADNI AVLT - List A Recall
(After B) Word 1 (After B) Word 1 (after B Recall), Word 1. 6 (After B) Word 1
page 118 of 1925

C101808 AVL01TN
Code Value
C102033 AVL01-List A Recognition AVL01-List A Recognition Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A
Intrusions Intrusions intrusions on recognition test. Recognition Intrusions
C102032 AVL01-List A Recognition AVL01-List A Recognition Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List A
Total Total words correct on recognition test. Recognition Total
C102014 AVL01-List B Intrusions AVL01-List B Intrusions Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List B
intrusions while recalling List B. Intrusions
C102013 AVL01-List B Recall Total AVL01-List B Recall Total Auditory Verbal Learning Test Version A - The number of ADNI AVLT - List B Recall
words recalled from List B. Total
C101998 AVL01-List B Recall Word AVL01-List B Recall Word Auditory Verbal Learning Test Version A - List B, Word 1. ADNI AVLT - List B Recall
1 1 Word 1
10 10 Word 10
11 11 Word 11
12 12 Word 12
13 13 Word 13
14 14 Word 14
15 15 Word 15
2 2 Word 2
3 3 Word 3
4 4 Word 4
5 5 Word 5
page 119 of 1925

C101808 AVL01TN
Code Value
6 6 Word 6
7 7 Word 7
8 8 Word 8
9 9 Word 9
page 120 of 1925

AVL02TC (Rey Auditory Verbal Learning Test Functional Test Test Code)
C123655 AVL02TC
Code Value
C123683 AVL0201 AVL02-List A Word 1 Auditory Verbal Learning Test - List A, Word 1. AVLT-REY - List A Word 1
C123692 AVL0210 AVL02-List A Word 10 Auditory Verbal Learning Test - List A, Word 10. AVLT-REY - List A Word
10
11
12
13
14
15
C123698 AVL0216 AVL02-List A Total Auditory Verbal Learning Test - The number of List A AVLT-REY - List A Total
words recalled from a trial.
C123699 AVL0217 AVL02-List A Intrusions Auditory Verbal Learning Test - The number of List A AVLT-REY - List A
intrusions while recalling from a trial. Intrusions
C123700 AVL0218 AVL02-List B Word 1 Auditory Verbal Learning Test - List B, Word 1. AVLT-REY - List B Word 1
C123709 AVL0227 AVL02-List B Word 10 Auditory Verbal Learning Test - List B, Word 10. AVLT-REY - List B Word
10
11
12
13
14
15
page 121 of 1925

C123655 AVL02TC
Code Value
C123715 AVL0233 AVL02- List B Total Auditory Verbal Learning Test - The number of words AVLT-REY - List B Total
recalled from List B trial.
C123716 AVL0234 AVL02-List B Intrusions Auditory Verbal Learning Test - The number of intrusions AVLT-REY - List B
while recalling from List B trial. Intrusions
C123717 AVL0235 AVL02-Recognition Total Auditory Verbal Learning Test - The number of words AVLT-REY - Recognition
correct on recognition test. Total
C123718 AVL0236 AVL02-Recognition Auditory Verbal Learning Test - The number of intrusions AVLT-REY - Recognition
Intrusions on recognition test. Intrusions
page 122 of 1925

AVL02TN (Rey Auditory Verbal Learning Test Functional Test Test Name)
C123654 AVL02TN
Code Value
C123715 AVL02- List B Total AVL02- List B Total Auditory Verbal Learning Test - The number of words AVLT-REY - List B Total
recalled from List B trial.
C123699 AVL02-List A Intrusions AVL02-List A Intrusions Auditory Verbal Learning Test - The number of List A AVLT-REY - List A
intrusions while recalling from a trial. Intrusions
C123698 AVL02-List A Total AVL02-List A Total Auditory Verbal Learning Test - The number of List A AVLT-REY - List A Total
words recalled from a trial.
C123683 AVL02-List A Word 1 AVL02-List A Word 1 Auditory Verbal Learning Test - List A, Word 1. AVLT-REY - List A Word 1
C123692 AVL02-List A Word 10 AVL02-List A Word 10 Auditory Verbal Learning Test - List A, Word 10. AVLT-REY - List A Word
10
11
12
13
14
15
C123716 AVL02-List B Intrusions AVL02-List B Intrusions Auditory Verbal Learning Test - The number of intrusions AVLT-REY - List B
while recalling from List B trial. Intrusions
C123700 AVL02-List B Word 1 AVL02-List B Word 1 Auditory Verbal Learning Test - List B, Word 1. AVLT-REY - List B Word 1
C123709 AVL02-List B Word 10 AVL02-List B Word 10 Auditory Verbal Learning Test - List B, Word 10. AVLT-REY - List B Word
10
11
12
13
14
15
page 123 of 1925

C123654 AVL02TN
Code Value
C123718 AVL02-Recognition AVL02-Recognition Auditory Verbal Learning Test - The number of intrusions AVLT-REY - Recognition
Intrusions Intrusions on recognition test. Intrusions
C123717 AVL02-Recognition Total AVL02-Recognition Total Auditory Verbal Learning Test - The number of words AVLT-REY - Recognition
correct on recognition test. Total
page 124 of 1925

AVOUTTRT (Anti-Viral Outcome of Treatment)
C120521 AVOUTTRT
Code Value
C120597 RAPID VIROLOGIC RVR A finding of aviremia at a specified timepoint, early during Rapid Virologic Response
RESPONSE the treatment period.
C120598 SUSTAINED VIROLOGIC SVR A finding of aviremia at a predetermined time point after Sustained Virologic
RESPONSE the end of planned or actual treatment. Response
C120599 VIRAL BREAKTHROUGH VBT The subject becomes viremic during the treatment period Viral Breakthrough
after a period of treatment-induced aviremia or has an
increase in viral load from nadir above a predetermined
threshold during the treatment period.
C120600 VIRAL RELAPSE A recurrence of the same virus after a finding of aviremia Viral Relapse
at the end of planned or actual treatment.
C120601 VIROLOGIC END OF A finding of aviremia at the end of the planned or actual Virologic End Of
TREATMENT RESPONSE end of treatment period. Treatment Response
C120602 VIROLOGIC FAILURE A finding of viremia at or after end of planned or actual Virologic Failure
treatment, excluding treatment discontinuations for non-
virologic reasons.
C120603 VIROLOGIC NON- The subject remains viremic during the treatment period. Virologic Non-Response
RESPONSE
C120604 VIROLOGIC NULL- The subject remains viremic during the treatment period Virologic Null-Response
RESPONSE and the decrease in viral load from baseline at a specified
timepoint is below or equal to a predetermined threshold.
C120605 VIROLOGIC PARTIAL The subject remains viremic during the treatment period Virologic Partial Response
RESPONSE and the decrease in viral load from baseline at a specified
timepoint is above a predetermined threshold.
page 125 of 1925

BACS1TC (Brief Assessment of Cognition in Schizophrenia Functional Test Test Code)
C120983 BACS1TC
Code Value
C121050 BACS101 BACS1-Number of Items Brief Assessment of Cognition in Schizophrenia - Verbal BACS - Number of Items
Recalled Memory-Number of items recalled on each trial. Recalled
C121051 BACS101A BACS1-Number of Items Brief Assessment of Cognition in Schizophrenia - Verbal BACS - Number of Items
Recalled Total Memory-Total number of items recalled. Recalled Total
C121052 BACS102 BACS1-Number of Correct Brief Assessment of Cognition in Schizophrenia - Digit BACS - Number of
Sequences Sequencing-Number of correct sequences. Correct Sequences
C121053 BACS103A BACS1-Number of Tokens Brief Assessment of Cognition in Schizophrenia - Token BACS - Number of Tokens
Left on the Table Motor Task-Total number of tokens left on the table. Left on the Table
C121054 BACS103B BACS1-Total Number Brief Assessment of Cognition in Schizophrenia - Token BACS - Total Number
Tokens in Container Motor Task-Total number of tokens placed in the Tokens in Container
container.
C121055 BACS103C BACS1-Number Tokens Brief Assessment of Cognition in Schizophrenia BACS - Number Tokens
Incorrectly Placed Questionnaire - Token Motor Task-Total number of tokens Incorrectly Placed
incorrectly placed in container.
C121056 BACS103D BACS1-Number of Tokens Brief Assessment of Cognition in Schizophrenia BACS - Number of Tokens
Correctly Placed Questionnaire - Token Motor Task-Number of tokens Correctly Placed
correctly placed.
C121057 BACS104A BACS1-Category Brief Assessment of Cognition in Schizophrenia BACS - Category

Instances Questionnaire - Verbal Fluency-Category instances. Instances
C121058 BACS104B BACS1-Letter Fluency 1 Brief Assessment of Cognition in Schizophrenia BACS - Letter Fluency 1
Questionnaire - Verbal Fluency-Letter fluency 1.
C121059 BACS104C BACS1-Letter Fluency 2 Brief Assessment of Cognition in Schizophrenia BACS - Letter Fluency 2
C121060 BACS104D BACS1-Verbal Fluency Brief Assessment of Cognition in Schizophrenia BACS - Verbal Fluency
Total Questionnaire - Verbal Fluency-Total number of Verbal Total
Fluency items.
C121061 BACS105 BACS1-Symbol Coding Brief Assessment of Cognition in Schizophrenia BACS - Symbol Coding
Raw Score Questionnaire - Symbol Coding-Raw score. Raw Score
C121062 BACS106 BACS1-Tower of London Brief Assessment of Cognition in Schizophrenia BACS - Tower of London
Correct Responses Questionnaire - Tower of London-Number of correct Correct Responses
responses.
page 126 of 1925

BACS1TN (Brief Assessment of Cognition in Schizophrenia Functional Test Test Name)
C120982 BACS1TN
Code Value
C121057 BACS1-Category BACS1-Category Brief Assessment of Cognition in Schizophrenia BACS - Category

Instances Instances Questionnaire - Verbal Fluency-Category instances. Instances
C121058 BACS1-Letter Fluency 1 BACS1-Letter Fluency 1 Brief Assessment of Cognition in Schizophrenia BACS - Letter Fluency 1
C121059 BACS1-Letter Fluency 2 BACS1-Letter Fluency 2 Brief Assessment of Cognition in Schizophrenia BACS - Letter Fluency 2
C121052 BACS1-Number of Correct BACS1-Number of Correct Brief Assessment of Cognition in Schizophrenia - Digit BACS - Number of
Sequences Sequences Sequencing-Number of correct sequences. Correct Sequences
C121050 BACS1-Number of Items BACS1-Number of Items Brief Assessment of Cognition in Schizophrenia - Verbal BACS - Number of Items
Recalled Recalled Memory-Number of items recalled on each trial. Recalled
C121051 BACS1-Number of Items BACS1-Number of Items Brief Assessment of Cognition in Schizophrenia - Verbal BACS - Number of Items
Recalled Total Recalled Total Memory-Total number of items recalled. Recalled Total
C121056 BACS1-Number of Tokens BACS1-Number of Tokens Brief Assessment of Cognition in Schizophrenia BACS - Number of Tokens
Correctly Placed Correctly Placed Questionnaire - Token Motor Task-Number of tokens Correctly Placed
correctly placed.
C121053 BACS1-Number of Tokens BACS1-Number of Tokens Brief Assessment of Cognition in Schizophrenia - Token BACS - Number of Tokens
Left on the Table Left on the Table Motor Task-Total number of tokens left on the table. Left on the Table
C121055 BACS1-Number Tokens BACS1-Number Tokens Brief Assessment of Cognition in Schizophrenia BACS - Number Tokens
Incorrectly Placed Incorrectly Placed Questionnaire - Token Motor Task-Total number of tokens Incorrectly Placed
incorrectly placed in container.
C121061 BACS1-Symbol Coding BACS1-Symbol Coding Brief Assessment of Cognition in Schizophrenia BACS - Symbol Coding
Raw Score Raw Score Questionnaire - Symbol Coding-Raw score. Raw Score
C121054 BACS1-Total Number BACS1-Total Number Brief Assessment of Cognition in Schizophrenia - Token BACS - Total Number
Tokens in Container Tokens in Container Motor Task-Total number of tokens placed in the Tokens in Container
container.
C121062 BACS1-Tower of London BACS1-Tower of London Brief Assessment of Cognition in Schizophrenia BACS - Tower of London
Correct Responses Correct Responses Questionnaire - Tower of London-Number of correct Correct Responses
responses.
C121060 BACS1-Verbal Fluency BACS1-Verbal Fluency Brief Assessment of Cognition in Schizophrenia BACS - Verbal Fluency
Total Total Questionnaire - Verbal Fluency-Total number of Verbal Total
Fluency items.
page 127 of 1925

BARS01TC (Barnes Akathisia Rating Scale Questionnaire Test Code)
C101809 BARS01TC
Code Value
C102046 BARS0101 BARS01-Objective Barnes Akathisia Rating Scale - Objective. BARS - Objective
C102047 BARS0102 BARS01-Subjective, Barnes Akathisia Rating Scale - Subjective, awareness of BARS - Subjective,
Awareness restlessness. Awareness
C102048 BARS0103 BARS01-Subjective, Barnes Akathisia Rating Scale - Subjective, distress BARS - Subjective,
Distress related to restlessness. Distress
C102049 BARS0104 BARS01-Global Clinical Barnes Akathisia Rating Scale - Global clinical assessment BARS - Global Clinical
Assessment of akathisia. Assessment
page 128 of 1925

BARS01TN (Barnes Akathisia Rating Scale Questionnaire Test Name)
C101810 BARS01TN
Code Value
C102049 BARS01-Global Clinical BARS01-Global Clinical Barnes Akathisia Rating Scale - Global clinical assessment BARS - Global Clinical
Assessment Assessment of akathisia. Assessment
C102046 BARS01-Objective BARS01-Objective Barnes Akathisia Rating Scale - Objective. BARS - Objective
C102047 BARS01-Subjective, BARS01-Subjective, Barnes Akathisia Rating Scale - Subjective, awareness of BARS - Subjective,
Awareness Awareness restlessness. Awareness
C102048 BARS01-Subjective, BARS01-Subjective, Barnes Akathisia Rating Scale - Subjective, distress BARS - Subjective,
Distress Distress related to restlessness. Distress
page 129 of 1925

BCR101TC (Borg CR10 Scale Questionnaire Test Code)
C113846 BCR101TC
Code Value
C113888 BCR10101 BCR101-Rating Borg CR10 Scale - Rating. Borg CR10 - Rating
page 130 of 1925

BCR101TN (Borg CR10 Scale Questionnaire Test Name)
C113845 BCR101TN
Code Value
C113888 BCR101-Rating BCR101-Rating Borg CR10 Scale - Rating. Borg CR10 - Rating
page 131 of 1925

BDI01TC (Baseline Dyspnea Index Questionnaire Test Code)
C106655 BDI01TC
Code Value
C106701 BDI0101 BDI01-Functional Baseline Dyspnea Index - Functional impairment. BDI - Functional
Impairment Impairment
C106702 BDI0102 BDI01-Magnitude of Task Baseline Dyspnea Index - Magnitude of task. BDI - Magnitude of Task
C106703 BDI0103 BDI01-Magnitude of Baseline Dyspnea Index - Magnitude of effort. BDI - Magnitude of Effort
Effort
page 132 of 1925

BDI01TN (Baseline Dyspnea Index Questionnaire Test Name)
C106654 BDI01TN
Code Value
C106701 BDI01-Functional BDI01-Functional Baseline Dyspnea Index - Functional impairment. BDI - Functional
Impairment Impairment Impairment
C106703 BDI01-Magnitude of BDI01-Magnitude of Baseline Dyspnea Index - Magnitude of effort. BDI - Magnitude of Effort
Effort Effort
C106702 BDI01-Magnitude of Task BDI01-Magnitude of Task Baseline Dyspnea Index - Magnitude of task. BDI - Magnitude of Task
page 133 of 1925

BEBQ01TC (Baby Eating Behaviour Questionnaire Concurrent Version Questionnaire Test Code)
C135680 BEBQ01TC
Code Value
C135775 BEBQ0101 BEBQ01-Baby Seems Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Contented Feeding baby seems contented while feeding. - Baby Seems Contented
Feeding
C135776 BEBQ0102 BEBQ01-Baby Frequently Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Wants More Milk baby frequently wants more milk than I provide. - Baby Frequently Wants
More Milk
C135777 BEBQ0103 BEBQ01-Baby Loves Milk Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
baby loves milk. - Baby Loves Milk
C135778 BEBQ0104 BEBQ01-Baby Has a Big Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Appetite baby has a big appetite. - Baby Has a Big Appetite
C135779 BEBQ0105 BEBQ01-Baby Finishes Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Feeding Quickly baby finishes feeding quickly. - Baby Finishes Feeding
Quickly
C135780 BEBQ0106 BEBQ01-Baby Becomes Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Distressed Feeding baby becomes distressed while feeding. - Baby Becomes
Distressed Feeding
C135781 BEBQ0107 BEBQ01-Baby Gets Full Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Up Easily baby gets full up easily. - Baby Gets Full Up Easily
C135782 BEBQ0108 BEBQ01-Baby Would Baby Eating Behaviour Questionnaire - Concurrent - If BEBQ Concurrent Version
Take Too Much Milk allowed to, my baby would take too much milk. - Baby Would Take Too
Much Milk
C135783 BEBQ0109 BEBQ01-Baby Takes More Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Than 30 Minutes baby takes more than 30 minutes to finish feeding. - Baby Takes More Than
30 Minutes
C135784 BEBQ0110 BEBQ01-Gets Full Before Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Taking All Milk baby gets full before taking all the milk I think he/she - Gets Full Before Taking
should have. All Milk
C135785 BEBQ0111 BEBQ01-Baby Feeds Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Slowly baby feeds slowly. - Baby Feeds Slowly
C135786 BEBQ0112 BEBQ01-Just Eaten Is Baby Eating Behaviour Questionnaire - Concurrent - Even BEBQ Concurrent Version
Happy to Feed Again when my baby has just eaten well he/she is happy to - Just Eaten Is Happy to
feed again if offered. Feed Again
C135787 BEBQ0113 BEBQ01-Difficult Manage Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Complete Feed baby finds it difficult to manage a complete feed. - Difficult Manage
Complete Feed
C135788 BEBQ0114 BEBQ01-Baby Is Always Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Demanding a Feed baby is always demanding a feed. - Baby Is Always
Demanding a Feed
C135789 BEBQ0115 BEBQ01-Baby Sucks More Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
and More Slowly baby sucks more and more slowly during the course of a - Baby Sucks More and
feed. More Slowly
C135790 BEBQ0116 BEBQ01-Baby Would Baby Eating Behaviour Questionnaire - Concurrent - If BEBQ Concurrent Version
Always Be Feeding given the chance, my baby would always be feeding. - Baby Would Always Be
Feeding
C135791 BEBQ0117 BEBQ01-Baby Enjoys Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Feeding Time baby enjoys feeding time. - Baby Enjoys Feeding
Time
C135792 BEBQ0118 BEBQ01-Take a Feed Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Within 30 Minutes baby can easily take a feed within 30 minutes of the last - Take a Feed Within 30
one. Minutes
page 134 of 1925

BEBQ01TN (Baby Eating Behaviour Questionnaire Concurrent Version Questionnaire Test Name)
C135679 BEBQ01TN
Code Value
C135780 BEBQ01-Baby Becomes BEBQ01-Baby Becomes Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Distressed Feeding Distressed Feeding baby becomes distressed while feeding. - Baby Becomes
Distressed Feeding
C135791 BEBQ01-Baby Enjoys BEBQ01-Baby Enjoys Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Feeding Time Feeding Time baby enjoys feeding time. - Baby Enjoys Feeding
Time
C135785 BEBQ01-Baby Feeds BEBQ01-Baby Feeds Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Slowly Slowly baby feeds slowly. - Baby Feeds Slowly
C135779 BEBQ01-Baby Finishes BEBQ01-Baby Finishes Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Feeding Quickly Feeding Quickly baby finishes feeding quickly. - Baby Finishes Feeding
Quickly
C135776 BEBQ01-Baby Frequently BEBQ01-Baby Frequently Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Wants More Milk Wants More Milk baby frequently wants more milk than I provide. - Baby Frequently Wants
More Milk
C135781 BEBQ01-Baby Gets Full BEBQ01-Baby Gets Full Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Up Easily Up Easily baby gets full up easily. - Baby Gets Full Up Easily
C135778 BEBQ01-Baby Has a Big BEBQ01-Baby Has a Big Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Appetite Appetite baby has a big appetite. - Baby Has a Big Appetite
C135788 BEBQ01-Baby Is Always BEBQ01-Baby Is Always Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Demanding a Feed Demanding a Feed baby is always demanding a feed. - Baby Is Always
Demanding a Feed
C135777 BEBQ01-Baby Loves Milk BEBQ01-Baby Loves Milk Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
baby loves milk. - Baby Loves Milk
C135775 BEBQ01-Baby Seems BEBQ01-Baby Seems Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Contented Feeding Contented Feeding baby seems contented while feeding. - Baby Seems Contented
Feeding
C135789 BEBQ01-Baby Sucks More BEBQ01-Baby Sucks More Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
and More Slowly and More Slowly baby sucks more and more slowly during the course of a - Baby Sucks More and
feed. More Slowly
C135783 BEBQ01-Baby Takes More BEBQ01-Baby Takes More Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Than 30 Minutes Than 30 Minutes baby takes more than 30 minutes to finish feeding. - Baby Takes More Than
30 Minutes
C135790 BEBQ01-Baby Would BEBQ01-Baby Would Baby Eating Behaviour Questionnaire - Concurrent - If BEBQ Concurrent Version
Always Be Feeding Always Be Feeding given the chance, my baby would always be feeding. - Baby Would Always Be
Feeding
C135782 BEBQ01-Baby Would BEBQ01-Baby Would Baby Eating Behaviour Questionnaire - Concurrent - If BEBQ Concurrent Version
Take Too Much Milk Take Too Much Milk allowed to, my baby would take too much milk. - Baby Would Take Too
Much Milk
C135787 BEBQ01-Difficult Manage BEBQ01-Difficult Manage Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Complete Feed Complete Feed baby finds it difficult to manage a complete feed. - Difficult Manage
Complete Feed
C135784 BEBQ01-Gets Full Before BEBQ01-Gets Full Before Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Taking All Milk Taking All Milk baby gets full before taking all the milk I think he/she - Gets Full Before Taking
should have. All Milk
C135786 BEBQ01-Just Eaten Is BEBQ01-Just Eaten Is Baby Eating Behaviour Questionnaire - Concurrent - Even BEBQ Concurrent Version
Happy to Feed Again Happy to Feed Again when my baby has just eaten well he/she is happy to - Just Eaten Is Happy to
feed again if offered. Feed Again
C135792 BEBQ01-Take a Feed BEBQ01-Take a Feed Baby Eating Behaviour Questionnaire - Concurrent - My BEBQ Concurrent Version
Within 30 Minutes Within 30 Minutes baby can easily take a feed within 30 minutes of the last - Take a Feed Within 30
one. Minutes
page 135 of 1925

BEBQ02TC (Baby Eating Behaviour Questionnaire Retrospective Version Questionnaire Test Code)
C135682 BEBQ02TC
Code Value
C135793 BEBQ0201 BEBQ02-Baby Seemed Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Contented Feeding baby seemed contented while feeding. Version - Baby Seemed
Contented Feeding
C135794 BEBQ0202 BEBQ02-Baby Frequently Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Wanted More Milk baby frequently wanted more milk than I provided. Version - Baby Frequently
Wanted More Milk
C135795 BEBQ0203 BEBQ02-Baby Loved Milk Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
baby loved milk. Version - Baby Loved Milk
C135796 BEBQ0204 BEBQ02-Baby Had a Big Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Appetite baby had a big appetite. Version - Baby Had a Big
Appetite
C135797 BEBQ0205 BEBQ02-Baby Finished Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Feeding Quickly baby finished feeding quickly. Version - Baby Finished
Feeding Quickly
C135798 BEBQ0206 BEBQ02-Baby Became Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Distressed Feeding baby became distressed while feeding. Version - Baby Became
Distressed Feeding
C135799 BEBQ0207 BEBQ02-Baby Got Full Up Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Easily baby got full up easily. Version - Baby Got Full
Up Easily
C135800 BEBQ0208 BEBQ02-Baby Would Baby Eating Behaviour Questionnaire - Retrospective - If BEBQ Retrospective
Take Too Much Milk allowed to, my baby would take too much milk. Version - Baby Would
Take Too Much Milk
C135801 BEBQ0209 BEBQ02-Baby Took More Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Than 30 Minutes baby took more than 30 minutes to finish feeding. Version - Baby Took More
Than 30 Minutes
C135802 BEBQ0210 BEBQ02-Got Full Before Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Taking All Milk baby got full before taking all the milk I think he/she Version - Got Full Before
should have. Taking All Milk
C135803 BEBQ0211 BEBQ02-Baby Fed Slowly Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
baby fed slowly. Version - Baby Fed Slowly
C135804 BEBQ0212 BEBQ02-Just Eaten Baby Eating Behaviour Questionnaire - Retrospective - BEBQ Retrospective
Happy to Feed Again Even when my baby had just eaten well he/she was Version - Just Eaten
happy to feed again if offered. Happy to Feed Again
C135805 BEBQ0213 BEBQ02-Difficult Manage Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Complete Feed baby found it difficult to manage a complete feed. Version - Difficult Manage
Complete Feed
C135806 BEBQ0214 BEBQ02-Baby Was Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Always Demanding a baby was always demanding a feed. Version - Baby Was
Feed Always Demanding a
Feed
C135807 BEBQ0215 BEBQ02-Baby Sucked Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
More and More Slowly baby sucked more and more slowly during the course of a Version - Baby Sucked
feed. More and More Slowly
C135808 BEBQ0216 BEBQ02-Baby Would Baby Eating Behaviour Questionnaire - Retrospective - If BEBQ Retrospective
Always Be Feeding given the chance, my baby would always be feeding. Version - Baby Would
Always Be Feeding
C135809 BEBQ0217 BEBQ02-Baby Enjoyed Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Feeding Time baby enjoyed feeding time. Version - Baby Enjoyed
Feeding Time
C135810 BEBQ0218 BEBQ02-Take a Feed Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Within 30 Minutes baby could easily take a feed within 30 minutes of the Version - Take a Feed
last one. Within 30 Minutes
page 136 of 1925

BEBQ02TN (Baby Eating Behaviour Questionnaire Retrospective Version Questionnaire Test Name)
C135681 BEBQ02TN
Code Value
C135798 BEBQ02-Baby Became BEBQ02-Baby Became Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Distressed Feeding Distressed Feeding baby became distressed while feeding. Version - Baby Became
Distressed Feeding
C135809 BEBQ02-Baby Enjoyed BEBQ02-Baby Enjoyed Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Feeding Time Feeding Time baby enjoyed feeding time. Version - Baby Enjoyed
Feeding Time
C135803 BEBQ02-Baby Fed Slowly BEBQ02-Baby Fed Slowly Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
baby fed slowly. Version - Baby Fed Slowly
C135797 BEBQ02-Baby Finished BEBQ02-Baby Finished Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Feeding Quickly Feeding Quickly baby finished feeding quickly. Version - Baby Finished
Feeding Quickly
C135794 BEBQ02-Baby Frequently BEBQ02-Baby Frequently Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Wanted More Milk Wanted More Milk baby frequently wanted more milk than I provided. Version - Baby Frequently
Wanted More Milk
C135799 BEBQ02-Baby Got Full Up BEBQ02-Baby Got Full Up Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Easily Easily baby got full up easily. Version - Baby Got Full
Up Easily
C135796 BEBQ02-Baby Had a Big BEBQ02-Baby Had a Big Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Appetite Appetite baby had a big appetite. Version - Baby Had a Big
Appetite
C135795 BEBQ02-Baby Loved Milk BEBQ02-Baby Loved Milk Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
baby loved milk. Version - Baby Loved Milk
C135793 BEBQ02-Baby Seemed BEBQ02-Baby Seemed Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Contented Feeding Contented Feeding baby seemed contented while feeding. Version - Baby Seemed
Contented Feeding
C135807 BEBQ02-Baby Sucked BEBQ02-Baby Sucked Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
More and More Slowly More and More Slowly baby sucked more and more slowly during the course of a Version - Baby Sucked
feed. More and More Slowly
C135801 BEBQ02-Baby Took More BEBQ02-Baby Took More Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Than 30 Minutes Than 30 Minutes baby took more than 30 minutes to finish feeding. Version - Baby Took More
Than 30 Minutes
C135806 BEBQ02-Baby Was BEBQ02-Baby Was Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Always Demanding a Always Demanding a baby was always demanding a feed. Version - Baby Was
Feed Feed Always Demanding a
Feed
C135808 BEBQ02-Baby Would BEBQ02-Baby Would Baby Eating Behaviour Questionnaire - Retrospective - If BEBQ Retrospective
Always Be Feeding Always Be Feeding given the chance, my baby would always be feeding. Version - Baby Would
Always Be Feeding
C135800 BEBQ02-Baby Would BEBQ02-Baby Would Baby Eating Behaviour Questionnaire - Retrospective - If BEBQ Retrospective
Take Too Much Milk Take Too Much Milk allowed to, my baby would take too much milk. Version - Baby Would
Take Too Much Milk
C135805 BEBQ02-Difficult Manage BEBQ02-Difficult Manage Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Complete Feed Complete Feed baby found it difficult to manage a complete feed. Version - Difficult Manage
Complete Feed
C135802 BEBQ02-Got Full Before BEBQ02-Got Full Before Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Taking All Milk Taking All Milk baby got full before taking all the milk I think he/she Version - Got Full Before
should have. Taking All Milk
C135804 BEBQ02-Just Eaten BEBQ02-Just Eaten Baby Eating Behaviour Questionnaire - Retrospective - BEBQ Retrospective
Happy to Feed Again Happy to Feed Again Even when my baby had just eaten well he/she was Version - Just Eaten
happy to feed again if offered. Happy to Feed Again
C135810 BEBQ02-Take a Feed BEBQ02-Take a Feed Baby Eating Behaviour Questionnaire - Retrospective - My BEBQ Retrospective
Within 30 Minutes Within 30 Minutes baby could easily take a feed within 30 minutes of the Version - Take a Feed
last one. Within 30 Minutes
page 137 of 1925

BEDECOD (Biospecimen Events Dictionary Derived Term)
C124297 BEDECOD
Code Value
C124326 ALIQUOTING The act of dividing a liquid item into multiple items of Aliquotting
smaller volume.
C154710 ARCHIVE RETRIEVING The act of removing a biological specimen from a biobank Archive Sample Retrieval
or other biorepository for further use.
C25453 COLLECTING The act of gathering an item. Collection
C85856 CONCENTRATING The act of increasing the density of a substance and Concentrate
decreasing its volume.
C17201 CULTURING The act of maintaining and/or attempting to grow Tissue Culture
explanted cells in an in vitro environment.
C68769 DECONTAMINATING The act of ridding of contamination. Decontamination
C62100 DESTROYING The act of demolishing an item to make it unusable or Destruction

unanalyzable.
C64657 DILUTING To reduce in strength or concentration by the addition of Dilute

diluent.
C48163 EMBEDDING To surround an object with a firm chemical substance Embedding

such as wax or resin.
C25219 FIXING To chemically preserve so as to maintain structural Fixation

and/or molecular features.
C63521 FLASH FREEZING To freeze rapidly so as to preserve structure and prevent Quick Freeze
ice crystal formation.
C48160 FREEZING The process whereby cold changes the water component Freezing
from a liquid to a solid.
C128947 ISOLATING The act of separating a molecular component from the Specimen Isolation
original specimen.
C25639 RECEIVING Coming into possession of or acting as the receptacle or Receive

recipient of an item conveyed by an intermediary to the
intended destination, from a sender.
C25659 RETRIEVING The act of accessing information or removing an item Retrieval

from storage.
C124327 SECTIONING To cut a very thin slice of tissue or other substance. Sectioning
C40353 SHIPPING Being transported or conveyed by an intermediary to a Shipping

destination, from the sender to the intended receiver.
C23010 STAINING To dye or tint tissues or other biological samples for the Staining Method
purpose of imaging structures.
C60824 STORING The act of safekeeping items in a depository. Storage
C48165 THAWING The process whereby heat changes the water component Thaw
from a solid to a liquid.
page 138 of 1925

BLCS01TC (Bladder Control Scale Questionnaire Test Code)
C113852 BLCS01TC
Code Value
C113953 BLCS0101 BLCS01-Lost Control of Bladder Control Scale - During the past 4 weeks, how BLCS - Lost Control of
Bladder often have you lost control of your bladder or had an Your Bladder
accident?
C113954 BLCS0102 BLCS01-Almost Lost Bladder Control Scale - During the past 4 weeks, how BLCS - Almost Lost
Control of Bladder often have you almost lost control of your bladder or had Control of Your Bladder
an accident?
C113955 BLCS0103 BLCS01-Altered Activity Bladder Control Scale - During the past 4 weeks, how BLCS - Altered Activities
Because Bladder often have you altered your activities because of bladder Because Bladder
problems? Problems
C113956 BLCS0104 BLCS01-Bladder Bladder Control Scale - During the past 4 weeks, how BLCS - Bladder Problems
Restricted Lifestyle much have bladder problems restricted your overall Restrict Overall Lifestyle
lifestyle?
page 139 of 1925

BLCS01TN (Bladder Control Scale Questionnaire Test Name)
C113851 BLCS01TN
Code Value
C113954 BLCS01-Almost Lost BLCS01-Almost Lost Bladder Control Scale - During the past 4 weeks, how BLCS - Almost Lost
Control of Bladder Control of Bladder often have you almost lost control of your bladder or had Control of Your Bladder
an accident?
C113955 BLCS01-Altered Activity BLCS01-Altered Activity Bladder Control Scale - During the past 4 weeks, how BLCS - Altered Activities
Because Bladder Because Bladder often have you altered your activities because of bladder Because Bladder
problems? Problems
C113956 BLCS01-Bladder BLCS01-Bladder Bladder Control Scale - During the past 4 weeks, how BLCS - Bladder Problems
Restricted Lifestyle Restricted Lifestyle much have bladder problems restricted your overall Restrict Overall Lifestyle
lifestyle?
C113953 BLCS01-Lost Control of BLCS01-Lost Control of Bladder Control Scale - During the past 4 weeks, how BLCS - Lost Control of
Bladder Bladder often have you lost control of your bladder or had an Your Bladder
accident?
page 140 of 1925

BODE01TC (The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index Clinical
Classification Test Code)
C120987 BODE01TC
Code Value
C121063 BODE0101 BODE01-Body-mass Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - Body-mass
Index Exercise Capacity Index - Body-mass index. Index
C121064 BODE0102 BODE01-FEV1 % Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - FEV1
Predicted Exercise Capacity Index - FEV1 (% of predicted). Percent Predicted
C121065 BODE0103 BODE01-MMRC Dyspnea Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - MMRC
Scale Exercise Capacity Index - MMRC dyspnea scale. Dyspnea Scale
C121066 BODE0104 BODE01-Distance Walked Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - Distance
in 6 Minutes Exercise Capacity Index - Distance walked in 6 min (in Walked in 6 Minutes
meter).
C121067 BODE0105 BODE01-BODE Score Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - Score
Exercise Capacity Index - BODE score.
page 141 of 1925

BODE01TN (The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index Clinical
Classification Test Name)
C120986 BODE01TN
Code Value
C121067 BODE01-BODE Score BODE01-BODE Score Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - Score
Exercise Capacity Index - BODE score.
C121063 BODE01-Body-mass BODE01-Body-mass Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - Body-mass
Index Index Exercise Capacity Index - Body-mass index. Index
C121066 BODE01-Distance Walked BODE01-Distance Walked Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - Distance
in 6 Minutes in 6 Minutes Exercise Capacity Index - Distance walked in 6 min (in Walked in 6 Minutes
meter).
C121064 BODE01-FEV1 % BODE01-FEV1 % Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - FEV1
Predicted Predicted Exercise Capacity Index - FEV1 (% of predicted). Percent Predicted
C121065 BODE01-MMRC Dyspnea BODE01-MMRC Dyspnea Body-Mass Index, Airflow Obstruction, Dyspnea, and BODE Index - MMRC
Scale Scale Exercise Capacity Index - MMRC dyspnea scale. Dyspnea Scale
page 142 of 1925

BPI1TC (Brief Pain Inventory Questionnaire Test Code)
C100162 BPI1TC
Code Value
C100287 BPI101 BPI1-Marital Status Brief Pain Inventory - Marital status. BPI - Marital Status
C100288 BPI102 BPI1-Education Brief Pain Inventory - Education. BPI - Education
C100289 BPI102A BPI1-Professional Degree Brief Pain Inventory - Education. Professional degree. BPI - Professional Degree
C100290 BPI103 BPI1-Current Occupation Brief Pain Inventory - Current occupation. BPI - Current Occupation
C100291 BPI104 BPI1-Spouse's Occupation Brief Pain Inventory - Spouse's occupation. BPI - Spouse's
Occupation
C100292 BPI105 BPI1-Current Job Status Brief Pain Inventory - Which of the following best BPI - Current Job Status
describes your current job status?
C100293 BPI106 BPI1-How Long Since Brief Pain Inventory - How long has it been since you first BPI - How Long Since
Diagnosis learned your diagnosis? Diagnosis
C100294 BPI107 BPI1-Pain Due to Present Brief Pain Inventory - Have you ever had pain due to your BPI - Pain Due to Present
Disease present disease? Disease
C100295 BPI108 BPI1-Pain One of Your Brief Pain Inventory - When you first received your BPI - Pain as a Symptom
Symptoms diagnosis, was pain one of your symptoms?
C100296 BPI109 BPI1-Surgery in Past Brief Pain Inventory - Have you had surgery in the past BPI - Surgery in Past
Month month? Month
C100297 BPI109A BPI1-Kind of Surgery in Brief Pain Inventory - What kind of surgery have you had BPI - Kind of Surgery in
Past Month in the past month? Past Month
C100298 BPI110 BPI1-Pain Other than Brief Pain Inventory - Have you had pain other than these BPI - Pain Other than
Everyday Kinds everyday kinds of pain during the last week? Everyday Kinds
C100299 BPI110A BPI1-Pain Medications in Brief Pain Inventory - Did you take pain medications in BPI - Pain Medications in
the Last 7 Days the last 7 days? the Last 7 Days
C100300 BPI110B BPI1-Pain Requires Brief Pain Inventory - I feel I have some form of pain that BPI - Pain Requires
Medication Daily requires medication each and every day. Medication Daily
C100301 BPI111A BPI1-Areas of Pain Brief Pain Inventory - On the diagram, shade in the areas BPI - Areas of Pain
where you feel pain.
C100302 BPI111B BPI1-Area Hurts Most Brief Pain Inventory - On the diagram, put an X on the BPI - Area Hurts Most
area that hurts the most.
C100303 BPI112 BPI1-Pain at its Worst in Brief Pain Inventory - Please rate your pain by circling the BPI - Pain at its Worst in
Last Week one number that best describes your pain at its worst in Last Week
the last week.
C100304 BPI113 BPI1-Pain at its Least in Brief Pain Inventory - Please rate your pain by circling the BPI - Pain at its Least in
Last Week one number that best describes your pain at its least in Last Week
the last week.
C100305 BPI114 BPI1-Pain on the Average Brief Pain Inventory - Please rate your pain by circling the BPI - Pain on the Average
one number that best describes your pain on the
average.
C100306 BPI115 BPI1-Pain Right Now Brief Pain Inventory - Please rate your pain by circling the BPI - Pain Right Now
one number that tells how much pain you have right now.
C100307 BPI116 BPI1-Things that Make Brief Pain Inventory - What kinds of things make your BPI - Things that Make
Pain Feel Better pain feel better? Pain Feel Better
C100308 BPI117 BPI1-Things that Make Brief Pain Inventory - What kinds of things make your BPI - Things that Make
your Pain Worse pain feel worse? your Pain Worse
C100309 BPI118 BPI1-Treatments Brief Pain Inventory - What treatments or medications BPI - Treatments
Receiving for Pain are you receiving for your pain? Receiving for Pain
C100310 BPI119 BPI1-Relief Pain Brief Pain Inventory - In the last week, how much relief BPI - Relief Pain
Treatments Provided have pain treatments or medications provided? Please Treatments Provided
circle the one percentage that most shows how much
relief you have received.
C100311 BPI120 BPI1-Hours before Pain Brief Pain Inventory - If you take pain medication, how BPI - Hours before Pain
Returns many hours does it take before the pain returns? Returns
C100312 BPI1211 BPI1-Pain Due to Effects Brief Pain Inventory - I believe my pain is due to the BPI - Pain Due to Effects
of Treatment effects of treatment. of Treatment
page 143 of 1925

C100162 BPI1TC
Code Value
C100313 BPI1212 BPI1-Pain Due to Primary Brief Pain Inventory - I believe my pain is due to my BPI - Pain Due to Primary
Disease primary disease. Disease
C100314 BPI1213 BPI1-Pain Due to Brief Pain Inventory - I believe my pain is due to a BPI - Pain Due to
Unrelated Med Condition medical condition unrelated to my primary disease. Unrelated Medical
Condition
C100315 BPI1213A BPI1-Describe Unrelated Brief Pain Inventory - I believe my pain is due to a BPI - Describe Unrelated
Med Condition medical condition unrelated to my primary disease. Medical Condition
Please describe condition.
C100316 BPI122A BPI1-Aching Brief Pain Inventory - Check Yes or No if the adjective BPI - Aching
applies to your pain: aching.
C100317 BPI122B BPI1-Throbbing Brief Pain Inventory - Check Yes or No if the adjective BPI - Throbbing
applies to your pain: throbbing.
C100318 BPI122C BPI1-Shooting Brief Pain Inventory - Check Yes or No if the adjective BPI - Shooting
applies to your pain: shooting.
C100319 BPI122D BPI1-Stabbing Brief Pain Inventory - Check Yes or No if the adjective BPI - Stabbing
applies to your pain: stabbing.
C100320 BPI122E BPI1-Gnawing Brief Pain Inventory - Check Yes or No if the adjective BPI - Gnawing
applies to your pain: gnawing.
C100321 BPI122F BPI1-Sharp Brief Pain Inventory - Check Yes or No if the adjective BPI - Sharp
applies to your pain: sharp.
C100322 BPI122G BPI1-Tender Brief Pain Inventory - Check Yes or No if the adjective BPI - Tender
applies to your pain: tender.
C100323 BPI122H BPI1-Burning Brief Pain Inventory - Check Yes or No if the adjective BPI - Burning
applies to your pain: burning.
C100324 BPI122I BPI1-Exhausting Brief Pain Inventory - Check Yes or No if the adjective BPI - Exhausting
applies to your pain: exhausting.
C100325 BPI122J BPI1-Tiring Brief Pain Inventory - Check Yes or No if the adjective BPI - Tiring
applies to your pain: tiring.
C100326 BPI122K BPI1-Penetrating Brief Pain Inventory - Check Yes or No if the adjective BPI - Penetrating
applies to your pain: penetrating.
C100327 BPI122L BPI1-Nagging Brief Pain Inventory - Check Yes or No if the adjective BPI - Nagging
applies to your pain: nagging.
C100328 BPI122M BPI1-Numb Brief Pain Inventory - Check Yes or No if the adjective BPI - Numb
applies to your pain: numb.
C100329 BPI122N BPI1-Miserable Brief Pain Inventory - Check Yes or No if the adjective BPI - Miserable
applies to your pain: miserable.
C100330 BPI122O BPI1-Unbearable Brief Pain Inventory - Check Yes or No if the adjective BPI - Unbearable
applies to your pain: unbearable.
C100331 BPI123A BPI1-Pain Interfered Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
General Activity describes how, during the past week, pain has interfered General Activity
with your general activity.
C100332 BPI123B BPI1-Pain Interfered with Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
Mood describes how, during the past week, pain has interfered Mood
with your mood.
C100333 BPI123C BPI1-Pain Interfered Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
Walking Ability describes how, during the past week, pain has interfered Walking Ability
with your walking ability.
C100334 BPI123D BPI1-Pain Interfered with Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
Normal Work describes how, during the past week, pain has interfered Normal Work
with your normal work.
C100335 BPI123E BPI1-Pain Interfered with Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
Relations describes how, during the past week, pain has interfered Relations
with your relations with other people.
C100336 BPI123F BPI1-Pain Interfered with Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
Sleep describes how, during the past week, pain has interfered Sleep
with your sleep.
C100337 BPI123G BPI1-Pain Interfered Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
Enjoyment of Life describes how, during the past week, pain has interfered Enjoyment of Life
with your enjoyment of life.
page 144 of 1925

C100162 BPI1TC
Code Value
C100338 BPI124 BPI1-Prefer to Take Pain Brief Pain Inventory - I prefer to take my pain medicine. BPI - Prefer to Take Pain
Medicine Medicine
C100339 BPI125 BPI1-Take my Pain Brief Pain Inventory - I take my pain medicine (in a 24 BPI - Take my Pain
Medicine hour period). Medicine
C100340 BPI126 BPI1-Need Stronger Type Brief Pain Inventory - Do you feel you need a stronger BPI - Need Stronger Type
of Pain Med type of pain medication? of Pain Medication
C100341 BPI127 BPI1-Need more Pain Med Brief Pain Inventory - Do you feel you need to take more BPI - Need more Pain
than Prescribed of the pain medication than your doctor has prescribed? Medication than
Prescribed
C100342 BPI128 BPI1-Concerned Use Too Brief Pain Inventory - Are you concerned that you use too BPI - Concerned with Too
Much Pain Med much pain medication? Much Pain Medication Use
C100343 BPI128A BPI1-Why Concerned Use Brief Pain Inventory - Are you concerned that you use too BPI - Why Concerned
Too Much Pain Med much pain medication? If Yes, why? with Too Much Pain
Medication Use
C100344 BPI129 BPI1-Problems with Side Brief Pain Inventory - Are you having problems with side BPI - Problems with Side
Effects Pain Med effects from your pain medication? Effects Pain Medication
C100345 BPI129A BPI1-Which Side Effects Brief Pain Inventory - Are you having problems with side BPI - What Side Effects
from Pain Med effects from your pain medication? Which side effects? from Pain Medication
C100346 BPI130 BPI1-Need Further Info Brief Pain Inventory - Do you feel you need to receive BPI - Need Further
about Pain Med further information about your pain medication? Information about Pain
Medication
C100347 BPI131A BPI1-Warm Compresses Brief Pain Inventory - Other methods I use to relieve pain BPI - Warm Compresses
to Relieve Pain include: warm compresses. to Relieve Pain
C100348 BPI131B BPI1-Cold Compresses to Brief Pain Inventory - Other methods I use to relieve pain BPI - Cold Compresses to
Relieve Pain include: cold compresses. Relieve Pain
C100349 BPI131C BPI1-Relaxation Brief Pain Inventory - Other methods I use to relieve pain BPI - Relaxation
Techniques Relieve Pain include: relaxation techniques. Techniques Relieve Pain
C100350 BPI131D BPI1-Distraction to Brief Pain Inventory - Other methods I use to relieve pain BPI - Distraction to
Relieve Pain include: distraction. Relieve Pain
C100351 BPI131E BPI1-Biofeedback to Brief Pain Inventory - Other methods I use to relieve pain BPI - Biofeedback to
Relieve Pain include: biofeedback. Relieve Pain
C100352 BPI131F BPI1-Hypnosis to Relieve Brief Pain Inventory - Other methods I use to relieve pain BPI - Hypnosis to Relieve
Pain include: hypnosis. Pain
C100353 BPI131G BPI1-Other to Relieve Brief Pain Inventory - Other methods I use to relieve pain BPI - Other Methods to
Pain include: other. Relieve Pain
C100354 BPI131H BPI1-Other specify to Brief Pain Inventory - Other methods I use to relieve pain BPI - Specified Other
Relieve Pain include: other. Please specify. Method to Relieve Pain
C100355 BPI132 BPI1-Meds not Prescribed Brief Pain Inventory - Medications not prescribed by my BPI - Medications not
Taken for Pain doctor that I take for pain are. Prescribed Taken for Pain
page 145 of 1925

BPI1TN (Brief Pain Inventory Questionnaire Test Name)
C100161 BPI1TN
Code Value
C100316 BPI1-Aching BPI1-Aching Brief Pain Inventory - Check Yes or No if the adjective BPI - Aching
applies to your pain: aching.
C100302 BPI1-Area Hurts Most BPI1-Area Hurts Most Brief Pain Inventory - On the diagram, put an X on the BPI - Area Hurts Most
area that hurts the most.
C100301 BPI1-Areas of Pain BPI1-Areas of Pain Brief Pain Inventory - On the diagram, shade in the areas BPI - Areas of Pain
where you feel pain.
C100351 BPI1-Biofeedback to BPI1-Biofeedback to Brief Pain Inventory - Other methods I use to relieve pain BPI - Biofeedback to
Relieve Pain Relieve Pain include: biofeedback. Relieve Pain
C100323 BPI1-Burning BPI1-Burning Brief Pain Inventory - Check Yes or No if the adjective BPI - Burning
applies to your pain: burning.
C100348 BPI1-Cold Compresses to BPI1-Cold Compresses to Brief Pain Inventory - Other methods I use to relieve pain BPI - Cold Compresses to
Relieve Pain Relieve Pain include: cold compresses. Relieve Pain
C100342 BPI1-Concerned Use Too BPI1-Concerned Use Too Brief Pain Inventory - Are you concerned that you use too BPI - Concerned with Too
Much Pain Med Much Pain Med much pain medication? Much Pain Medication Use
C100292 BPI1-Current Job Status BPI1-Current Job Status Brief Pain Inventory - Which of the following best BPI - Current Job Status
describes your current job status?
C100290 BPI1-Current Occupation BPI1-Current Occupation Brief Pain Inventory - Current occupation. BPI - Current Occupation
C100315 BPI1-Describe Unrelated BPI1-Describe Unrelated Brief Pain Inventory - I believe my pain is due to a BPI - Describe Unrelated
Med Condition Med Condition medical condition unrelated to my primary disease. Medical Condition
Please describe condition.
C100350 BPI1-Distraction to BPI1-Distraction to Brief Pain Inventory - Other methods I use to relieve pain BPI - Distraction to
Relieve Pain Relieve Pain include: distraction. Relieve Pain
C100288 BPI1-Education BPI1-Education Brief Pain Inventory - Education. BPI - Education
C100324 BPI1-Exhausting BPI1-Exhausting Brief Pain Inventory - Check Yes or No if the adjective BPI - Exhausting
applies to your pain: exhausting.
C100320 BPI1-Gnawing BPI1-Gnawing Brief Pain Inventory - Check Yes or No if the adjective BPI - Gnawing
applies to your pain: gnawing.
C100311 BPI1-Hours before Pain BPI1-Hours before Pain Brief Pain Inventory - If you take pain medication, how BPI - Hours before Pain
Returns Returns many hours does it take before the pain returns? Returns
C100293 BPI1-How Long Since BPI1-How Long Since Brief Pain Inventory - How long has it been since you first BPI - How Long Since
Diagnosis Diagnosis learned your diagnosis? Diagnosis
C100352 BPI1-Hypnosis to Relieve BPI1-Hypnosis to Relieve Brief Pain Inventory - Other methods I use to relieve pain BPI - Hypnosis to Relieve
Pain Pain include: hypnosis. Pain
C100297 BPI1-Kind of Surgery in BPI1-Kind of Surgery in Brief Pain Inventory - What kind of surgery have you had BPI - Kind of Surgery in
Past Month Past Month in the past month? Past Month
C100287 BPI1-Marital Status BPI1-Marital Status Brief Pain Inventory - Marital status. BPI - Marital Status
C100355 BPI1-Meds not Prescribed BPI1-Meds not Prescribed Brief Pain Inventory - Medications not prescribed by my BPI - Medications not
Taken for Pain Taken for Pain doctor that I take for pain are. Prescribed Taken for Pain
C100329 BPI1-Miserable BPI1-Miserable Brief Pain Inventory - Check Yes or No if the adjective BPI - Miserable
applies to your pain: miserable.
C100327 BPI1-Nagging BPI1-Nagging Brief Pain Inventory - Check Yes or No if the adjective BPI - Nagging
applies to your pain: nagging.
C100346 BPI1-Need Further Info BPI1-Need Further Info Brief Pain Inventory - Do you feel you need to receive BPI - Need Further
about Pain Med about Pain Med further information about your pain medication? Information about Pain
Medication
C100341 BPI1-Need more Pain Med BPI1-Need more Pain Med Brief Pain Inventory - Do you feel you need to take more BPI - Need more Pain
than Prescribed than Prescribed of the pain medication than your doctor has prescribed? Medication than
Prescribed
C100340 BPI1-Need Stronger Type BPI1-Need Stronger Type Brief Pain Inventory - Do you feel you need a stronger BPI - Need Stronger Type
of Pain Med of Pain Med type of pain medication? of Pain Medication
C100328 BPI1-Numb BPI1-Numb Brief Pain Inventory - Check Yes or No if the adjective BPI - Numb
applies to your pain: numb.
page 146 of 1925

C100161 BPI1TN
Code Value
C100354 BPI1-Other specify to BPI1-Other specify to Brief Pain Inventory - Other methods I use to relieve pain BPI - Specified Other
Relieve Pain Relieve Pain include: other. Please specify. Method to Relieve Pain
C100353 BPI1-Other to Relieve BPI1-Other to Relieve Brief Pain Inventory - Other methods I use to relieve pain BPI - Other Methods to
Pain Pain include: other. Relieve Pain
C100304 BPI1-Pain at its Least in BPI1-Pain at its Least in Brief Pain Inventory - Please rate your pain by circling the BPI - Pain at its Least in
Last Week Last Week one number that best describes your pain at its least in Last Week
the last week.
C100303 BPI1-Pain at its Worst in BPI1-Pain at its Worst in Brief Pain Inventory - Please rate your pain by circling the BPI - Pain at its Worst in
Last Week Last Week one number that best describes your pain at its worst in Last Week
the last week.
C100312 BPI1-Pain Due to Effects BPI1-Pain Due to Effects Brief Pain Inventory - I believe my pain is due to the BPI - Pain Due to Effects
of Treatment of Treatment effects of treatment. of Treatment
C100294 BPI1-Pain Due to Present BPI1-Pain Due to Present Brief Pain Inventory - Have you ever had pain due to your BPI - Pain Due to Present
Disease Disease present disease? Disease
C100313 BPI1-Pain Due to Primary BPI1-Pain Due to Primary Brief Pain Inventory - I believe my pain is due to my BPI - Pain Due to Primary
Disease Disease primary disease. Disease
C100314 BPI1-Pain Due to BPI1-Pain Due to Brief Pain Inventory - I believe my pain is due to a BPI - Pain Due to
Unrelated Med Condition Unrelated Med Condition medical condition unrelated to my primary disease. Unrelated Medical
Condition
C100337 BPI1-Pain Interfered BPI1-Pain Interfered Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
Enjoyment of Life Enjoyment of Life describes how, during the past week, pain has interfered Enjoyment of Life
with your enjoyment of life.
General Activity General Activity describes how, during the past week, pain has interfered General Activity
with your general activity.
Walking Ability Walking Ability describes how, during the past week, pain has interfered Walking Ability
with your walking ability.
C100332 BPI1-Pain Interfered with BPI1-Pain Interfered with Brief Pain Inventory - Circle the one number that BPI - Pain Interfered with
Mood Mood describes how, during the past week, pain has interfered Mood
with your mood.
Normal Work Normal Work describes how, during the past week, pain has interfered Normal Work
with your normal work.
Relations Relations describes how, during the past week, pain has interfered Relations
with your relations with other people.
Sleep Sleep describes how, during the past week, pain has interfered Sleep
with your sleep.
C100299 BPI1-Pain Medications in BPI1-Pain Medications in Brief Pain Inventory - Did you take pain medications in BPI - Pain Medications in
the Last 7 Days the Last 7 Days the last 7 days? the Last 7 Days
C100305 BPI1-Pain on the Average BPI1-Pain on the Average Brief Pain Inventory - Please rate your pain by circling the BPI - Pain on the Average
one number that best describes your pain on the
average.
C100295 BPI1-Pain One of Your BPI1-Pain One of Your Brief Pain Inventory - When you first received your BPI - Pain as a Symptom
Symptoms Symptoms diagnosis, was pain one of your symptoms?
C100298 BPI1-Pain Other than BPI1-Pain Other than Brief Pain Inventory - Have you had pain other than these BPI - Pain Other than
Everyday Kinds Everyday Kinds everyday kinds of pain during the last week? Everyday Kinds
C100300 BPI1-Pain Requires BPI1-Pain Requires Brief Pain Inventory - I feel I have some form of pain that BPI - Pain Requires
Medication Daily Medication Daily requires medication each and every day. Medication Daily
C100306 BPI1-Pain Right Now BPI1-Pain Right Now Brief Pain Inventory - Please rate your pain by circling the BPI - Pain Right Now
one number that tells how much pain you have right now.
C100326 BPI1-Penetrating BPI1-Penetrating Brief Pain Inventory - Check Yes or No if the adjective BPI - Penetrating
applies to your pain: penetrating.
C100338 BPI1-Prefer to Take Pain BPI1-Prefer to Take Pain Brief Pain Inventory - I prefer to take my pain medicine. BPI - Prefer to Take Pain
Medicine Medicine Medicine
C100344 BPI1-Problems with Side BPI1-Problems with Side Brief Pain Inventory - Are you having problems with side BPI - Problems with Side
Effects Pain Med Effects Pain Med effects from your pain medication? Effects Pain Medication
page 147 of 1925

C100161 BPI1TN
Code Value
C100289 BPI1-Professional Degree BPI1-Professional Degree Brief Pain Inventory - Education. Professional degree. BPI - Professional Degree
C100349 BPI1-Relaxation BPI1-Relaxation Brief Pain Inventory - Other methods I use to relieve pain BPI - Relaxation
Techniques Relieve Pain Techniques Relieve Pain include: relaxation techniques. Techniques Relieve Pain
C100310 BPI1-Relief Pain BPI1-Relief Pain Brief Pain Inventory - In the last week, how much relief BPI - Relief Pain
Treatments Provided Treatments Provided have pain treatments or medications provided? Please Treatments Provided
circle the one percentage that most shows how much
relief you have received.
C100321 BPI1-Sharp BPI1-Sharp Brief Pain Inventory - Check Yes or No if the adjective BPI - Sharp
applies to your pain: sharp.
C100318 BPI1-Shooting BPI1-Shooting Brief Pain Inventory - Check Yes or No if the adjective BPI - Shooting
applies to your pain: shooting.
C100291 BPI1-Spouse's Occupation BPI1-Spouse's Occupation Brief Pain Inventory - Spouse's occupation. BPI - Spouse's
Occupation
C100319 BPI1-Stabbing BPI1-Stabbing Brief Pain Inventory - Check Yes or No if the adjective BPI - Stabbing
applies to your pain: stabbing.
C100296 BPI1-Surgery in Past BPI1-Surgery in Past Brief Pain Inventory - Have you had surgery in the past BPI - Surgery in Past
Month Month month? Month
C100339 BPI1-Take my Pain BPI1-Take my Pain Brief Pain Inventory - I take my pain medicine (in a 24 BPI - Take my Pain
Medicine Medicine hour period). Medicine
C100322 BPI1-Tender BPI1-Tender Brief Pain Inventory - Check Yes or No if the adjective BPI - Tender
applies to your pain: tender.
C100307 BPI1-Things that Make BPI1-Things that Make Brief Pain Inventory - What kinds of things make your BPI - Things that Make
Pain Feel Better Pain Feel Better pain feel better? Pain Feel Better
C100308 BPI1-Things that Make BPI1-Things that Make Brief Pain Inventory - What kinds of things make your BPI - Things that Make
your Pain Worse your Pain Worse pain feel worse? your Pain Worse
C100317 BPI1-Throbbing BPI1-Throbbing Brief Pain Inventory - Check Yes or No if the adjective BPI - Throbbing
applies to your pain: throbbing.
C100325 BPI1-Tiring BPI1-Tiring Brief Pain Inventory - Check Yes or No if the adjective BPI - Tiring
applies to your pain: tiring.
C100309 BPI1-Treatments BPI1-Treatments Brief Pain Inventory - What treatments or medications BPI - Treatments
Receiving for Pain Receiving for Pain are you receiving for your pain? Receiving for Pain
C100330 BPI1-Unbearable BPI1-Unbearable Brief Pain Inventory - Check Yes or No if the adjective BPI - Unbearable
applies to your pain: unbearable.
C100347 BPI1-Warm Compresses BPI1-Warm Compresses Brief Pain Inventory - Other methods I use to relieve pain BPI - Warm Compresses
to Relieve Pain to Relieve Pain include: warm compresses. to Relieve Pain
C100345 BPI1-Which Side Effects BPI1-Which Side Effects Brief Pain Inventory - Are you having problems with side BPI - What Side Effects
from Pain Med from Pain Med effects from your pain medication? Which side effects? from Pain Medication
C100343 BPI1-Why Concerned Use BPI1-Why Concerned Use Brief Pain Inventory - Are you concerned that you use too BPI - Why Concerned
Too Much Pain Med Too Much Pain Med much pain medication? If Yes, why? with Too Much Pain
Medication Use
page 148 of 1925

BPI2TC (Brief Pain Inventory Short Form Questionnaire Test Code)
C100164 BPI2TC
Code Value
C100356 BPI201 BPI2-Pain Other Than Brief Pain Inventory Short Form - Have you had pain BPI Short Form - Pain
Everyday Kinds other than these everyday kinds of pain today? Other Than Everyday
Kinds
C100357 BPI202A BPI2-Areas of Pain Brief Pain Inventory Short Form - On the diagram, shade BPI Short Form - Areas of
in the areas where you feel pain. Pain
C100358 BPI202B BPI2-Area Hurts Most Brief Pain Inventory Short Form - On the diagram, put an BPI Short Form - Area
X on the area that hurts the most. that Hurts Most
C100359 BPI203 BPI2-Pain at its Worst in Brief Pain Inventory Short Form - Please rate your pain BPI Short Form - Pain at
Last 24 Hours by circling the one number that best describes your pain its Worst in Last 24 Hours
at its worst in the last 24 hours.
C100360 BPI204 BPI2-Pain at its Least in Brief Pain Inventory Short Form - Please rate your pain BPI Short Form - Pain at
Last 24 Hours by circling the one number that best describes your pain its Least in Last 24 Hours
at its least in the last 24 hours.
C100361 BPI205 BPI2-Pain on the Average Brief Pain Inventory Short Form - Please rate your pain BPI Short Form - Pain on
by circling the one number that best describes your pain the Average
on the average.
C100362 BPI206 BPI2-Pain Right Now Brief Pain Inventory Short Form - Please rate your pain BPI Short Form - Pain
by circling the one number that tells how much pain you Right Now
have right now.
C100363 BPI207 BPI2-Treatments Brief Pain Inventory Short Form - What treatments or BPI Short Form -
Receiving for Pain medications are you receiving for your pain? Treatments or
Medications Receiving for
Pain
C100364 BPI208 BPI2-Relief Pain Brief Pain Inventory Short Form - In the last 24 hours, BPI Short Form - Relief
Treatments Provided how much relief have pain treatments or medications from Pain Treatments
provided? Please circle the one percentage that most Provided
shows how much relief you have received.
C100365 BPI209A BPI2-Pain Interfered Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
General Activity that describes how, during the past 24 hours, pain has Interfered with General
interfered with your general activity. Activity
C100366 BPI209B BPI2-Pain Interfered with Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
Mood that describes how, during the past 24 hours, pain has Interfered with Mood
interfered with your mood.
C100367 BPI209C BPI2-Pain Interfered Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
Walking Ability that describes how, during the past 24 hours, pain has Interfered with Walking
interfered with your walking ability. Ability
C100368 BPI209D BPI2-Pain Interfered with Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
Normal Work that describes how, during the past 24 hours, pain has Interfered with Normal
interfered with your normal work. Work
C100369 BPI209E BPI2-Pain Interfered with Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
Relations that describes how, during the past 24 hours, pain has Interfered with Relations
interfered with your relations with other people.
C100370 BPI209F BPI2-Pain Interfered with Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
Sleep that describes how, during the past 24 hours, pain has Interfered with Sleep
interfered with your sleep.
C100371 BPI209G BPI2-Pain Interfered Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
Enjoyment of Life that describes how, during the past 24 hours, pain has Interfered with
interfered with your enjoyment of life. Enjoyment of Life
page 149 of 1925

BPI2TN (Brief Pain Inventory Short Form Questionnaire Test Name)
C100163 BPI2TN
Code Value
C100358 BPI2-Area Hurts Most BPI2-Area Hurts Most Brief Pain Inventory Short Form - On the diagram, put an BPI Short Form - Area
X on the area that hurts the most. that Hurts Most
C100357 BPI2-Areas of Pain BPI2-Areas of Pain Brief Pain Inventory Short Form - On the diagram, shade BPI Short Form - Areas of
in the areas where you feel pain. Pain
C100360 BPI2-Pain at its Least in BPI2-Pain at its Least in Brief Pain Inventory Short Form - Please rate your pain BPI Short Form - Pain at
Last 24 Hours Last 24 Hours by circling the one number that best describes your pain its Least in Last 24 Hours
at its least in the last 24 hours.
C100359 BPI2-Pain at its Worst in BPI2-Pain at its Worst in Brief Pain Inventory Short Form - Please rate your pain BPI Short Form - Pain at
Last 24 Hours Last 24 Hours by circling the one number that best describes your pain its Worst in Last 24 Hours
at its worst in the last 24 hours.
C100371 BPI2-Pain Interfered BPI2-Pain Interfered Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
Enjoyment of Life Enjoyment of Life that describes how, during the past 24 hours, pain has Interfered with
interfered with your enjoyment of life. Enjoyment of Life
General Activity General Activity that describes how, during the past 24 hours, pain has Interfered with General
interfered with your general activity. Activity
Walking Ability Walking Ability that describes how, during the past 24 hours, pain has Interfered with Walking
interfered with your walking ability. Ability
C100366 BPI2-Pain Interfered with BPI2-Pain Interfered with Brief Pain Inventory Short Form - Circle the one number BPI Short Form - Pain
Mood Mood that describes how, during the past 24 hours, pain has Interfered with Mood
interfered with your mood.
Normal Work Normal Work that describes how, during the past 24 hours, pain has Interfered with Normal
interfered with your normal work. Work
Relations Relations that describes how, during the past 24 hours, pain has Interfered with Relations
interfered with your relations with other people.
Sleep Sleep that describes how, during the past 24 hours, pain has Interfered with Sleep
interfered with your sleep.
C100361 BPI2-Pain on the Average BPI2-Pain on the Average Brief Pain Inventory Short Form - Please rate your pain BPI Short Form - Pain on
by circling the one number that best describes your pain the Average
on the average.
C100356 BPI2-Pain Other Than BPI2-Pain Other Than Brief Pain Inventory Short Form - Have you had pain BPI Short Form - Pain
Everyday Kinds Everyday Kinds other than these everyday kinds of pain today? Other Than Everyday
Kinds
C100362 BPI2-Pain Right Now BPI2-Pain Right Now Brief Pain Inventory Short Form - Please rate your pain BPI Short Form - Pain
by circling the one number that tells how much pain you Right Now
have right now.
C100364 BPI2-Relief Pain BPI2-Relief Pain Brief Pain Inventory Short Form - In the last 24 hours, BPI Short Form - Relief
Treatments Provided Treatments Provided how much relief have pain treatments or medications from Pain Treatments
provided? Please circle the one percentage that most Provided
shows how much relief you have received.
C100363 BPI2-Treatments BPI2-Treatments Brief Pain Inventory Short Form - What treatments or BPI Short Form -
Receiving for Pain Receiving for Pain medications are you receiving for your pain? Treatments or
Medications Receiving for
Pain
page 150 of 1925

BPR01TC (Brief Psychiatric Rating Scale-A Questionnaire Test Code)
C100134 BPR01TC
Code Value
C100372 BPR0101 BPR01-Somatic Concern Brief Psychiatric Rating Scale-A - Somatic Concern. BPRS-A - Somatic
Concern
C100373 BPR0102 BPR01-Anxiety Brief Psychiatric Rating Scale-A - Anxiety. BPRS-A - Anxiety
C100374 BPR0103 BPR01-Emotional Brief Psychiatric Rating Scale-A - Emotional Withdrawal. BPRS-A - Emotional
Withdrawal Withdrawal
C100375 BPR0104 BPR01-Conceptual Brief Psychiatric Rating Scale-A - Conceptual BPRS-A - Conceptual
Disorganization Disorganization. Disorganization
C100376 BPR0105 BPR01-Guilt Feelings Brief Psychiatric Rating Scale-A - Guilt Feelings. BPRS-A - Guilt Feelings
C100377 BPR0106 BPR01-Tension Brief Psychiatric Rating Scale-A - Tension. BPRS-A - Tension
C100378 BPR0107 BPR01-Mannerisms and Brief Psychiatric Rating Scale-A - Mannerisms and BPRS-A - Mannerisms and
Posturing Posturing. Posturing
C100379 BPR0108 BPR01-Grandiosity Brief Psychiatric Rating Scale-A - Grandiosity. BPRS-A - Grandiosity
C100380 BPR0109 BPR01-Depressive Mood Brief Psychiatric Rating Scale-A - Depressive Mood. BPRS-A - Depressive
Mood
C100381 BPR0110 BPR01-Hostility Brief Psychiatric Rating Scale-A - Hostility. BPRS-A - Hostility
C100382 BPR0111 BPR01-Suspiciousness Brief Psychiatric Rating Scale-A - Suspiciousness. BPRS-A - Suspiciousness
C100383 BPR0112 BPR01-Hallucinatory Brief Psychiatric Rating Scale-A - Hallucinatory Behavior. BPRS-A - Hallucinatory
Behavior Behavior
C100384 BPR0113 BPR01-Motor Retardation Brief Psychiatric Rating Scale-A - Motor Retardation. BPRS-A - Motor
Retardation
C100385 BPR0114 BPR01-Uncooperativeness Brief Psychiatric Rating Scale-A - Uncooperativeness. BPRS-A -

Uncooperativeness
C100386 BPR0115 BPR01-Unusual Thought Brief Psychiatric Rating Scale-A - Unusual Thought BPRS-A - Unusual
Content Content. Thought Content
C100387 BPR0116 BPR01-Blunted Affect Brief Psychiatric Rating Scale-A - Blunted Affect. BPRS-A - Blunted Affect
C100388 BPR0117 BPR01-Excitement Brief Psychiatric Rating Scale-A - Excitement. BPRS-A - Excitement
C100389 BPR0118 BPR01-Disorientation Brief Psychiatric Rating Scale-A - Disorientation. BPRS-A - Disorientation
page 151 of 1925

BPR01TN (Brief Psychiatric Rating Scale-A Questionnaire Test Name)
C100133 BPR01TN
Code Value
C100373 BPR01-Anxiety BPR01-Anxiety Brief Psychiatric Rating Scale-A - Anxiety. BPRS-A - Anxiety
C100387 BPR01-Blunted Affect BPR01-Blunted Affect Brief Psychiatric Rating Scale-A - Blunted Affect. BPRS-A - Blunted Affect
C100375 BPR01-Conceptual BPR01-Conceptual Brief Psychiatric Rating Scale-A - Conceptual BPRS-A - Conceptual
Disorganization Disorganization Disorganization. Disorganization
C100380 BPR01-Depressive Mood BPR01-Depressive Mood Brief Psychiatric Rating Scale-A - Depressive Mood. BPRS-A - Depressive
Mood
C100389 BPR01-Disorientation BPR01-Disorientation Brief Psychiatric Rating Scale-A - Disorientation. BPRS-A - Disorientation
C100374 BPR01-Emotional BPR01-Emotional Brief Psychiatric Rating Scale-A - Emotional Withdrawal. BPRS-A - Emotional
Withdrawal Withdrawal Withdrawal
C100388 BPR01-Excitement BPR01-Excitement Brief Psychiatric Rating Scale-A - Excitement. BPRS-A - Excitement
C100379 BPR01-Grandiosity BPR01-Grandiosity Brief Psychiatric Rating Scale-A - Grandiosity. BPRS-A - Grandiosity
C100376 BPR01-Guilt Feelings BPR01-Guilt Feelings Brief Psychiatric Rating Scale-A - Guilt Feelings. BPRS-A - Guilt Feelings
C100383 BPR01-Hallucinatory BPR01-Hallucinatory Brief Psychiatric Rating Scale-A - Hallucinatory Behavior. BPRS-A - Hallucinatory
Behavior Behavior Behavior
C100381 BPR01-Hostility BPR01-Hostility Brief Psychiatric Rating Scale-A - Hostility. BPRS-A - Hostility
C100378 BPR01-Mannerisms and BPR01-Mannerisms and Brief Psychiatric Rating Scale-A - Mannerisms and BPRS-A - Mannerisms and
Posturing Posturing Posturing. Posturing
C100384 BPR01-Motor Retardation BPR01-Motor Retardation Brief Psychiatric Rating Scale-A - Motor Retardation. BPRS-A - Motor
Retardation
C100372 BPR01-Somatic Concern BPR01-Somatic Concern Brief Psychiatric Rating Scale-A - Somatic Concern. BPRS-A - Somatic
Concern
C100382 BPR01-Suspiciousness BPR01-Suspiciousness Brief Psychiatric Rating Scale-A - Suspiciousness. BPRS-A - Suspiciousness
C100377 BPR01-Tension BPR01-Tension Brief Psychiatric Rating Scale-A - Tension. BPRS-A - Tension
C100385 BPR01-Uncooperativeness BPR01-Uncooperativeness Brief Psychiatric Rating Scale-A - Uncooperativeness. BPRS-A -

Uncooperativeness
C100386 BPR01-Unusual Thought BPR01-Unusual Thought Brief Psychiatric Rating Scale-A - Unusual Thought BPRS-A - Unusual
Content Content Content. Thought Content
page 152 of 1925

BRDGMOOD (BRIDG Activity Mood)
C125923 BRDGMOOD
Code Value
C38000 PERFORMED To execute and carry through to completion. Performed
C125937 SCHEDULED To order a planned list of activities or events. Scheduled
page 153 of 1925

BSTEST (Biospecimen Characteristics Test Name)
C124299 BSTEST
Code Value
C139281 A260/A230 Ratio A260/A230 Ratio An assessment of nucleic acid purity that is measured by A260 to A230 Ratio
determining the ratio of light absorbance of the nucleic
acid sample at 260nm and 230nm respectively.
C139280 A260/A280 Ratio A260/A280 Ratio An assessment of nucleic acid purity that is measured by A260 to A280 Ratio
C25244 Area Area The extent of a 2-dimensional surface enclosed within a Area
boundary. (NCI)
C41185 Concentration Concentration The quantity of a specified substance in a unit volume or Concentration
weight of another substance.
C128948 Fixative Name Fixative Name The name of the substance or material that preserves Name of Fixative
tissues and cells for study.
C139282 Fluorescent Label Fluorescent Label The type of fluorescent label or dye that is used in a Fluorescent Tag Type
fluorescence-based assay.
C25334 Length Length The linear extent in space from one end of something to Length
the other end, or the extent of something from beginning
to end. (NCI)
C43246 Mass Mass The amount of matter in an object. Mass
C25283 Quality Quality An assessment of excellence, worth, or fitness for use. Quality
C63637 RNA Integrity Number RNA Integrity Number A numerical assessment of the integrity of RNA based on RNA Integrity Number
the entire electrophoretic trace of the RNA sample,
including the presence or absence of degradation
products. (NCI)
C139279 Sample Viability Indicator Sample Viability Indicator An indication as to whether the sample contains viable Sample Viability Indicator
(capable of life or normal growth and development) cells
or tissues.
C139278 Sample Viability Percent Sample Viability Percent A measurement of the percent of a sample that is viable Sample Viability Percent
(capable of life or normal growth and development) for Measurement
further processing or testing.
C25681 Size Size The physical magnitude of something. (NCI) Size
C106569 Specimen Weight Specimen Weight A measurement of the weight of a biological specimen. Specimen Weight
Measurement
C25206 Temperature Temperature The property of a body or region of space that determines Temperature
whether or not there will be a net flow of heat into it or
out of it from a neighboring body or region and in which
direction (if any) the heat will flow, perceptible by living
organism as a somatic sensation of cold or heat. It is a
measure of the average translational kinetic energy
associated with the disordered microscopic motion of
atoms and molecules. Temperature is measured in one of
the three standard temperature scales: Celsius, Kelvin,
and Fahrenheit. (NCI)
C41145 Thickness Thickness The dimension between two surfaces of an object, usually Thickness
the smallest dimension as opposed to the width or the
length.
C135371 Tumor Tissue Origin Tumor Tissue Origin A characterization of the tumor tissue sample based upon Tumor Tissue Origin
whether it was taken from a tumor that originated after
the disease spread.
C25335 Volume Volume The amount of three dimensional space occupied by an Volume
object or the capacity of a space or container. (NCI)
C25345 Width Width The extent or measurement of something from side to Width
side. (NCI)
page 154 of 1925

BSTESTCD (Biospecimen Characteristics Test Code)
C124300 BSTESTCD
Code Value
C139281 A260A230 A260/A230 Ratio An assessment of nucleic acid purity that is measured by A260 to A230 Ratio
C139280 A260A280 A260/A280 Ratio An assessment of nucleic acid purity that is measured by A260 to A280 Ratio
C25244 AREA Area The extent of a 2-dimensional surface enclosed within a Area
boundary. (NCI)
C41185 CONC Concentration The quantity of a specified substance in a unit volume or Concentration
weight of another substance.
C128948 FIXNAM Fixative Name The name of the substance or material that preserves Name of Fixative
tissues and cells for study.
C139282 FLUORLBL Fluorescent Label The type of fluorescent label or dye that is used in a Fluorescent Tag Type
fluorescence-based assay.
C25334 LENGTH Length The linear extent in space from one end of something to Length
to end. (NCI)
C43246 MASS Mass The amount of matter in an object. Mass
C25283 QUALITY Quality An assessment of excellence, worth, or fitness for use. Quality
C63637 RIN RNA Integrity Number A numerical assessment of the integrity of RNA based on RNA Integrity Number
the entire electrophoretic trace of the RNA sample,
including the presence or absence of degradation
products. (NCI)
C25681 SIZE Size The physical magnitude of something. (NCI) Size
C106569 SPWEIGHT Specimen Weight A measurement of the weight of a biological specimen. Specimen Weight
Measurement
C25206 TEMP Temperature The property of a body or region of space that determines Temperature
C41145 THICK Thickness The dimension between two surfaces of an object, usually Thickness
length.
C135371 TUMTORI Tumor Tissue Origin A characterization of the tumor tissue sample based upon Tumor Tissue Origin
whether it was taken from a tumor that originated after
the disease spread.
C139279 VBLSIND Sample Viability Indicator An indication as to whether the sample contains viable Sample Viability Indicator
(capable of life or normal growth and development) cells
or tissues.
C139278 VBLSPCT Sample Viability Percent A measurement of the percent of a sample that is viable Sample Viability Percent
(capable of life or normal growth and development) for Measurement
further processing or testing.
C25335 VOLUME Volume The amount of three dimensional space occupied by an Volume
object or the capacity of a space or container. (NCI)
C25345 WIDTH Width The extent or measurement of something from side to Width
side. (NCI)
page 155 of 1925

BUERS1TC (Brooke Upper Extremity Rating Scale Clinical Classification Test Code)
C130239 BUERS1TC
Code Value
C130326 BUERS101 BUERS1-Brooke Upper Brooke Upper Extremity Rating Scale - Brooke upper BUERS - Brooke Upper
Extremity Rating extremity rating scale. Extremity Rating Scale
page 156 of 1925

BUERS1TN (Brooke Upper Extremity Rating Scale Clinical Classification Test Name)
C130238 BUERS1TN
Code Value
C130326 BUERS1-Brooke Upper BUERS1-Brooke Upper Brooke Upper Extremity Rating Scale - Brooke upper BUERS - Brooke Upper
Extremity Rating Extremity Rating extremity rating scale. Extremity Rating Scale
page 157 of 1925

BWCS01TC (Bowel Control Scale Questionnaire Test Code)
C113854 BWCS01TC
Code Value
C113957 BWCS0101 BWCS01-Been Bowel Control Scale - During the past 4 weeks, how often BWCS - Been Constipated
Constipated have you been constipated?
C113958 BWCS0102 BWCS01-Lost Control of Bowel Control Scale - During the past 4 weeks, how often BWCS - Lost Control of
Bowels have you lost control of your bowels or had an accident? Your Bowels
C113959 BWCS0103 BWCS01-Almost Lost Bowel Control Scale - During the past 4 weeks, how often BWCS - Almost Lost
Control of Bowels have you almost lost control of your bowels or almost had Control of Your Bowels
an accident?
C113960 BWCS0104 BWCS01-Altered Activity Bowel Control Scale - During the past 4 weeks, how often BWCS - Altered Activities
Because Bowels have you altered your activities because of bowel control Because Bowel Control
problems? Problems
C113961 BWCS0105 BWCS01-Bowels Bowel Control Scale - During the past 4 weeks, how much BWCS - Bowel Problems
Restricted Lifestyle have bowel problems restricted your overall lifestyle? Restrict Overall Lifestyle
page 158 of 1925

BWCS01TN (Bowel Control Scale Questionnaire Test Name)
C113853 BWCS01TN
Code Value
C113959 BWCS01-Almost Lost BWCS01-Almost Lost Bowel Control Scale - During the past 4 weeks, how often BWCS - Almost Lost
Control of Bowels Control of Bowels have you almost lost control of your bowels or almost had Control of Your Bowels
an accident?
C113960 BWCS01-Altered Activity BWCS01-Altered Activity Bowel Control Scale - During the past 4 weeks, how often BWCS - Altered Activities
Because Bowels Because Bowels have you altered your activities because of bowel control Because Bowel Control
problems? Problems
C113957 BWCS01-Been BWCS01-Been Bowel Control Scale - During the past 4 weeks, how often BWCS - Been Constipated
Constipated Constipated have you been constipated?
C113961 BWCS01-Bowels BWCS01-Bowels Bowel Control Scale - During the past 4 weeks, how much BWCS - Bowel Problems
Restricted Lifestyle Restricted Lifestyle have bowel problems restricted your overall lifestyle? Restrict Overall Lifestyle
C113958 BWCS01-Lost Control of BWCS01-Lost Control of Bowel Control Scale - During the past 4 weeks, how often BWCS - Lost Control of
Bowels Bowels have you lost control of your bowels or had an accident? Your Bowels
page 159 of 1925

CACRDSC (Canadian Cardiovascular Society Classification)
C101842 CACRDSC
Code Value
C77265 CCS CLASS 1 Canadian Cardiovascular Ordinary physical activity, such as walking or climbing Canadian Cardiovascular
Society Classification 1 stairs, does not cause angina. Angina occurs with Society Grading Scale
strenuous, rapid, or prolonged exertion at work or Class I
recreation.
C77266 CCS CLASS 2 Canadian Cardiovascular Slight limitation of ordinary activity. Angina occurs on Canadian Cardiovascular
Society Classification 2 walking or climbing stairs rapidly, walking uphill, walking Society Grading Scale
or climbing stairs after meals, or in cold, in wind, or Class II
under emotional stress, or only during the few hours after
awakening. Angina occurs on walking more than 2 blocks
on the level and climbing more than 1 flight of ordinary
stairs at a normal pace and in normal conditions.
C77267 CCS CLASS 3 Canadian Cardiovascular Marked limitations of ordinary physical activity. Angina Canadian Cardiovascular
Society Classification 3 occurs on walking 1 to 2 blocks on the level and climbing Society Grading Scale
1 flight of stairs in normal conditions and at a normal Class III
pace.
C77268 CCS CLASS 4 Canadian Cardiovascular Inability to perform any physical activity without Canadian Cardiovascular
Society Classification 4 discomfort - anginal symptoms may be present at rest. Society Grading Scale
Class IV
page 160 of 1925

CADG01TC (Coronary Artery Dissection NHLBI Grade Clinical Classification Test Code)
C119076 CADG01TC
Code Value
C119196 CADG0101 CADG01-Coronary Coronary Artery Dissection NHLBI Grade - A grading NHLBI CAD Grade -
Dissection NHLBI Grade system to describe coronary artery dissection per the Coronary Artery
NHLBI, American College of Cardiology, American Heart Dissection NHLBI Grade
Association.
page 161 of 1925

CADG01TN (Coronary Artery Dissection NHLBI Grade Clinical Classification Test Name)
C119075 CADG01TN
Code Value
C119196 CADG01-Coronary CADG01-Coronary Coronary Artery Dissection NHLBI Grade - A grading NHLBI CAD Grade -
Dissection NHLBI Grade Dissection NHLBI Grade system to describe coronary artery dissection per the Coronary Artery
NHLBI, American College of Cardiology, American Heart Dissection NHLBI Grade
Association.
page 162 of 1925

CADGRS (Coronary Artery Dissection NHLBI Grade Responses)
C119018 CADGRS
Code Value
C119588 CORONARY DISSECTION Minor radiolucencies within the lumen during contrast NHLBI Coronary Artery
NHLBI GRADE A injection with no persistence after dye clearance. Dissection Type A
(Adapted from: Coronary artery angiographic changes
after PTCA: Manual of Operations NHLBI PTCA Registry
1985-6:9)
C119589 CORONARY DISSECTION Parallel tracts or double lumen separated by a radiolucent NHLBI Coronary Artery
NHLBI GRADE B area during contrast injection with no persistence after Dissection Type B
dye clearance. (Adapted from: Coronary artery
angiographic changes after PTCA: Manual of Operations
NHLBI PTCA Registry 1985-6:9)
C119590 CORONARY DISSECTION Extraluminal cap with persistence of contrast after dye NHLBI Coronary Artery
NHLBI GRADE C clearance from the lumen. (Adapted from: Coronary Dissection Type C
artery angiographic changes after PTCA: Manual of
Operations NHLBI PTCA Registry 1985-6:9)
C119591 CORONARY DISSECTION Spiral luminal filling defect with delayed but complete NHLBI Coronary Artery
NHLBI GRADE D distal flow. (Adapted from: Coronary artery angiographic Dissection Type D
changes after PTCA: Manual of Operations NHLBI PTCA
Registry 1985-6:9)
C119592 CORONARY DISSECTION New persistent filling defect with delayed antegrade flow. NHLBI Coronary Artery
NHLBI GRADE E May represent thrombus. (Adapted from: Coronary artery Dissection Type E
angiographic changes after PTCA: Manual of Operations
NHLBI PTCA Registry 1985-6:9)
C119593 CORONARY DISSECTION Non-A-E types with total coronary occlusion and no distal NHLBI Coronary Artery
NHLBI GRADE F antegrade flow. May represent thrombus. (Adapted from: Dissection Type F
Coronary artery angiographic changes after PTCA: Manual
of Operations NHLBI PTCA Registry 1985-6:9)
page 163 of 1925

CADPRSN (Coronary Artery Disease Presentation)
C101843 CADPRSN
Code Value
C80383 NON-ST ELEVATION NON-STEMI;NSTEMI A myocardial infarction that does not produce elevation in Non-ST Elevation
MYOCARDIAL the ST segments of the ECG. Myocardial Infarction by
INFARCTION ECG Finding
C101888 ST ELEVATION STEMI A myocardial infarction that produces elevation in the ST ST Elevation Myocardial
MYOCARDIAL segments of the ECG. Infarction by ECG Finding
INFARCTION
C66914 STABLE ANGINA Angina pectoris which has not recently changed in Stable Angina
frequency, duration or intensity. Stable angina pectoris is
relieved by rest or administration of oral, sublingual or
transdermal antianginal medications.
C66911 UNSTABLE ANGINA Angina pectoris (or equivalent type of ischemic Unstable Angina
discomfort) which has recently changed in frequency,
duration, intensity, or occurs at rest.
C66915 VARIANT ANGINA A variant form of angina pectoris caused by coronary Variant Angina
artery vasospasm, usually occurring spontaneously and
frequently associated with ST segment elevation.
page 164 of 1925

CADRISK (Coronary Artery Disease Risk)
C101849 CADRISK
Code Value
C99955 HIGH CAD RISK High Coronary Artery The likelihood an individual will develop coronary artery High Coronary Artery
Disease Risk disease is almost certain or greater than 90%. (Gibbons Disease Risk
RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF,
Froelicher VF, Mark DB, McCallister BD, Mooss AN,
O'Reilly MG, Winters WL Jr. ACC/AHA 2002 guideline
update for exercise testing: a report of the American
College of Cardiology/American Heart Association Task
Force on Practice Guidelines (Committee on Exercise
Testing). 2002. American College of Cardiology Web site.
Available at:
www.acc.org/clinical/guidelines/exercise/dirIndex.htm.)
C99966 INTERMEDIATE CAD RISK Intermediate Coronary The likelihood an individual will develop coronary artery Intermediate Coronary
Artery Disease Risk disease (CAD) is moderate or between 10% and 90%. Artery Disease Risk
(Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher
GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN,
Available at:
C99968 KNOWN CAD Known Coronary Artery The individual has coronary artery disease (CAD). Known Coronary Artery
Disease (Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher Disease
GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN,
Available at:
C99978 LOW CAD RISK Low Coronary Artery The likelihood an individual will develop coronary artery Low Coronary Artery
Disease Risk disease (CAD) is minimal or less than10%.(Gibbons RJ, Disease Risk
Balady GJ, Bricker JT, Chaitman BR, Fletcher GF,
Froelicher VF, Mark DB, McCallister BD, Mooss AN,
Available at:
page 165 of 1925

CADSYMP (Coronary Artery Disease Symptoms)
C101844 CADSYMP
Code Value
C99917 ATYPICAL CORONARY Sharp stabbing chest pain or reproduction of pain on Atypical Coronary Artery
ARTERY DISEASE palpation. Less common isolated presentations, primarily Disease Symptom
SYMPTOMS in older adults, include nausea and vomiting, diaphoresis,
and unexplained fatigue. J Am Coll Cardiol, 2007; 50:1-
157, doi:10.1016/j.jacc.2007.02.013 (Published online 6
August 2007).
C3833 NO SYMPTOMS The finding of no indications of a particular disease or Asymptomatic

injury.
C78504 NON-CARDIAC CHEST A discomfort in the chest area that is not related to the Non-Cardiac Chest Pain
PAIN heart.
C100024 TYPICAL CORONARY Deep, poorly localized chest or arm discomfort that is Typical Coronary Artery
ARTERY DISEASE reproducibly associated with physical exertion or Disease Symptom
SYMPTOMS emotional stress and is relieved promptly (ie, in less than
5 minutes) with rest and/or the use of sublingual
nitroglycerin. Some patients may have no chest
discomfort but present solely with jaw, neck, ear, arm,
shoulder, back, or epigastric discomfort or with
unexplained dyspnea without discomfort. If these
symptoms have a clear relationship to exertion or stress
or are relieved promptly with nitrates, they should be
considered equivalent to angina. J Am Coll Cardiol, 2007;
50:1-157, doi:10.1016/j.jacc.2007.02.013 (Published
online 6 August 2007).
page 166 of 1925

CARTDOM (Coronary Artery Dominance)
C101860 CARTDOM
Code Value
C99941 CO-DOMINANT The right coronary artery supplies the posterior Co-Dominant Artery
descending artery and the circumflex supplies the
posterolateral branches.
C99971 LEFT DOMINANT The left circumflex artery supplies the posterior Left Cardiac Artery
descending artery and the posterolateral branches. Dominance
C99942 RIGHT DOMINANT The right coronary artery supplies the posterior Coronary Artery Right
descending artery and the posterolateral branches. Dominance
page 167 of 1925

CASEFIND (Case Finding)
C127263 CASEFIND
Code Value
C127515 ACTIVE CASE SEARCH Purposefully looking for subjects with a particular Active Case Search
characteristic or disease.
C127516 PASSIVE CASE SEARCH Finding subjects with a particular characteristic or disease Passive Case Search
without actively searching.
page 168 of 1925

CCCAT (Category of Clinical Classification)
C1189 CCCAT
71
NCI CDISC Submission CDISC Synonym CDISC Definition NCI Preferred

Code Value Term
C12575 AJCC V7 AJCC1 AJCC TNM Staging System 7th Edition (AJCC V7) (Edge SB, Byrd DR, AJCC Cancer
5 Compton CC, Fritz AG, Greene FL, Trotti A, editors. AJCC cancer staging Staging Manual 7th
manual (7th ed). New York, NY: Springer; 2010). Edition
C12100 APACHE II APCH1 Acute Physiology and Chronic Health Evaluation II (APACHE II) (Knaus WA, Acute Physiology
5 Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease and Chronic Health
classification system. Critical Care Medicine 1985; 13(10):818-29). Evaluation II Clinical
Classification
C11910 ARC STC GRADE STCG01 Stent Thrombosis Coronary ARC Grade (Cutlip DE, Windecker S, Mehran R, Stent Thrombosis
7 et al. Clinical End Points in Coronary Stent Trials : A Case for Standardized Coronary ARC
Definitions. Circulation. 2007;115:2344-2351). Grade Clinical
Classification
C12470 ASCVD 10-YEAR ASCVD1 Atherosclerotic Cardiovascular Disease 10-Year Risk Estimator (Goff Jr DC et Atherosclerotic
5 RISK al. 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk: A Cardiovascular
Report of the American College of Cardiology/American Heart Association Disease 10-Year
Task Force on Practice Guidelines. Circulation 2014; 129: S49-S73). Risk Estimator
Clinical
Classification
C12470 ASSIGN CVD 10- ASSG01 ASSIGN Cardiovascular Disease 10-Year Risk Score (Woodward M, Brindle P, ASSIGN
6 YEAR RISK Tunstall-Pedoe H, for the SIGN group on risk estimation. Adding social Cardiovascular
deprivation and family history to cardiovascular risk assessment: the Disease 10-Year
ASSIGN score from the Scottish Heart Health Extended Cohort (SHHEC). Risk Score Clinical
Heart 2007; 93: 172-176). Classification
C14758 ATLAS ATLAS1 Age, treatment with systemic antibiotics, leukocyte count, serum albumin, ATLAS Score Clinical
9 and serum creatinine as a measure of renal function (ATLAS) (Miller, M.A., Classification
Louie,T., Mullane, K., Weiss, K., Lentnek, A., Golan, Y., et al. (2013).
Derivation and validation of a simple clinical bedside score (ATLAS) for
Clostridium difficile infection which predicts response to therapy. BMC
Infectious Diseases, 13: 148).
C12100 BODE INDEX BODE01 The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity The Body-Mass
6 Index (BODE Index) (Bartolome R. Celli, M.D., Claudia G. Cote, M.D., Jose Index, Airflow
M. Marin, M.D., Ciro Casanova, M.D., Maria Montes de Oca, M.D., Reina A. Obstruction,
Mendez, M.D., Victor Pinto Plata, M.D., and Howard J. Cabral, Ph.D.; N Engl J Dyspnea, and
Med 2004;350:1005-12). Exercise Capacity
Index Clinical
Classification
C13030 BUERS BUERS1 Brooke Upper Extremity Rating Scale (BUERS)(Brooke MG, Griggs RC, Brooke Upper
4 Mendell JR, Fenichel, GM, Shumate JB and Peggegrino RJ (1981). Clinical Extremity Rating
trial in duchenne dystrophy. I The Design of the Protocol. Muscle and Nerve: Scale Clinical
4:186-197). Classification
C12471 CDC HIV CHIVC1 CDC Classification System for HIV-Infected Adults and Adolescents (Centers Center for Disease
5 CLASSIFICATION for Disease Control and Prevention. 1993 Revised Classification System for Control and
FOR ADULTS AND HIV Infection and Expanded Surveillance Case Definition for AIDS Among Prevention
ADOLESCENTS Adolescents and Adults. MMWR Recomm Rep. 1992 Dec 18;41(RR-17):1- Classification
19). System for HIV-
Infected Adults and
Classification
C15532 CDRS-R CDRS01 Children's Depression Rating Scale, Revised (CDRS-R) - (Copyright 1995 by Children's
3 WESTERN PSYCHOLOGICAL SERVICES. Not to be reproduced in whole or in Depression Rating
part without written permission. All rights reserved). Scale, Revised
Clinical
Classification
C12100 CHILD-PUGH CPS01 Child-Pugh Classification (Guidance for Industry Pharmacokinetics in Patients Child-Pugh Clinical
7 CLASSIFICATION with Impaired Hepatic Function: Study Design, Data Analysis, and Impact on Classification
Dosing and Labeling. U.S. Department of Health and Human Services; Food
and Drug Administration; Center for Drug Evaluation and Research (CDER);
Center for Biologics Evaluation and Research (CBER). May 2003, Clinical
Pharmacology.
http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInform
ation/Guidances/UCM072123.pdf;
http://www.halaven.com/sites/default/files/ChildPugh_FlashCard.pdf).
C12471 CRS-R CRSR01 JFK Coma Recovery Scale-Revised (CRS-R) (Joseph T. Giacino, Kathleen JFK Coma Recovery
1 Kalmar, John Whyte. The JFK Coma Recovery Scale-Revised: Measurement Scale-Revised
Characteristics and Diagnostic Utility. Arch Phys Med Rehabil Vol 85, Clinical
December 2004). Classification
page 169 of 1925

C1189 CCCAT
71

Code Value Term
C11799 ESRSA ESRSA1 Extrapyramidal Symptom Rating Scale-Abbreviated (ESRS-A) (Copyright Extrapyramidal
7 2006 Larry Alphs, MD, PhD, Guy Chouinard, MD, All Rights Reserved). Symptom Rating
Scale-Abbreviated
Clinical
Classification
C12470 FHS CVD 10-YEAR FCVD1 Framingham Heart Study Cardiovascular Disease 10-Year Risk Score Framingham Heart
7 RISK (D'Agostino Sr RB, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Study
and Kannel WB. General Cardiovascular Risk Profile for Use in Primary Care: Cardiovascular
The Framingham Heart Study. Circulation 2008; 117: 743-753). Disease 10-Year
Risk Score Clinical
Classification
C12471 GCS NINDS GCS01 Glasgow Coma Scale (GCS) The National Institute of Neurological Disorders Glasgow Coma
0 VERSION and Stroke (NINDS) Version (Graham Teasdale and Bryan Jennett. Scale-NINDS
Assessment of coma and impaired consciousness. A practical scale. Lancet. Version Clinical
1974 Jul 13; 2(7872):81-4). Classification
C10211 HAM-A HAMA1 The Hamilton Anxiety Rating Scale (HAM-A) (Hamilton M. The assessment of Hamilton Anxiety
8 anxiety states by rating. Br J Med Psychol 1959; 32:50-55). Rating Scale Clinical
Classification
C10076 HAMD 17 HAMD1 The Hamilton Depression Rating Scale 17-Item (HAMD 17) (Hamilton M. Hamilton
7 Development of a rating scale for primary depressive illness. Br J Soc Clin Depression Rating
Psychol 1967; 6(4):278-96). Scale 17 Item
Clinical
Classification
C10211 HAMD 21 HAMD2 The Hamilton Depression Rating Scale 21-Item (HAMD 21) (Hedlund and Hamilton
9 Vieweg, The Hamilton rating scale for depression. Journal of Operational Depression Rating
Psychiatry, 1979;10(2):149-165). Scale 21-Item
Clinical
Classification
C13030 HAMD 24 HAMD3 The Hamilton Depression Rating Scale 24-Item (HAM-D24) (Clinical Hamilton
7 Psychometrics: Per Bech, MD; John Wiley & Sons, Ltd. 2012). Depression Rating
Scale-24 Item
Clinical
Classification
C13030 HAMD 6 CLINICIAN HAMD4 The Hamilton Depression Rating Scale 6 - Clinician Version (HAM-D6 - Hamilton
6 VERSION Clinician Version) (Clinical Research: Rating scales in depression: limitations Depression Rating
and pitfalls; Per Bech, MD; Copyright 2006 LLS SAS. All rights reserved). Scale 6 Clinician
Version Clinical
Classification
C13833 HAS-BLED HSB01 HAS-BLED Bleeding Risk Score (HAS-BLED) (This image was published in HAS-BLED Bleeding
2 Chest, 138 (5), Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJ, Lip Risk Score Clinical
GY, A Novel User-Friendly Score (HAS-BLED) To Assess 1-Year Risk of Major Classification
Bleeding in Patients With Atrial Fibrillation: The Euro Heart Survey, Copyright
Elsevier (2010). http://www.sciencedirect.com/science/journal/00123692).
C13030 IDS-C IDSC1 Inventory of Depressive Symptomatology - Clinician-Rated (IDS-C) Inventory of

8 (Copyright UT Southwestern Medical Center at Dallas. Rush, A.J., Giles, D.E., Depressive
Schlesser, M.A., Fulton, C.L.,Weissenburger, J.E. and Burns, C.T. The Symptomatology
Inventory of Depressive Symptomatology (IDS): Preliminary findings. Clinician-Rated
Psychiatry Research, 18:65-87, 1986). Version Clinical
Classification
C13031 KDPI KDPI01 Kidney Donor Profile Index (KDPI) (OPTN/UNOS. A guide to calculating and Kidney Donor Profile
0 interpreting the Kidney Donor Profile Index (KDPI). [Accessed April 18, Index Clinical
2016]. Available at: Classification
https://optn.transplant.hrsa.gov/media/1512/guide_to_calculating_interpreti
ng_kdpi.pdf. Rao PS, Schaubel DE, Guidinger MK, et al. A comprehensive
risk quantification score for deceased donor kidneys: the kidney donor risk
index. Transplantation 2009 Jul 27;88(2):231-6).
C13833 LPPS SCALE LPPSS1 The Lansky Play-Performance Status Scale (LPSS) (Lansky SB, List MA, The Lansky Play-
3 Lansky LL, Ritter-Sterr C, Miller DR. The measurement of performance in Performance Status
childhood cancer patients. Cancer. 1987 Oct 1;60(7):1651-6). Scale Clinical
Classification
C12100 MELD MELD01 Model for End Stage Liver Disease (MELD) (Malinchoc M, Kamath PS, Gordon Model for End Stage
8 FD, Peine CJ, Rank J, ter Borg PC (April 2000). A model to predict poor Liver Disease
survival in patients undergoing transjugular intrahepatic portosystemic Clinical
shunts. Hepatology 31 (4): 864-71). Classification
C11910 NHLBI CAD GRADE CADG01 Coronary Artery Dissection NHLBI Grade (Coronary Artery angiographic Coronary Artery
5 changes after PTCA: Manual of Operations NHBLI PTCA Registry 1985-6:9). Dissection NHLBI
Grade Clinical
Classification
page 170 of 1925

C1189 CCCAT
71

Code Value Term
C12100 NSA-16 NSA01 Negative Symptom Assessment-16 (NSA-16) (Version 2.0, Copyright 2006, Negative Symptom
9 Larry Alphs, MD, PhD, All Right Reserved). Assessment-16
Clinical
Classification
C13253 NSAA NSAA1 North Star Ambulatory Assessment (NSAA) (Copyright the North Star Clinical North Star
1 Network UK. Scott E, Eagle M, Mayhew A, Freeman J, Main M, Sheehan J, Ambulatory
Manzur A, Muntoni F; North Star Clinical Network for Paediatric Assessment Clinical
Neuromuscular Disease. Development of a functional assessment scale for Classification
ambulatory boys with Duchenne muscular dystrophy. Physiother Res Int.
2012 Jun;17(2):101-9. The support of Muscular Dystrophy United Kingdom
in developing the North Star Ambulatory Assessment is gratefully
acknowledged).
C12471 PANSS PANSS1 Positive and Negative Syndrome Scale (PANSS) (Copyright 1992 Multi-Health Positive and
2 Systems Inc. All rights reserved). Negative Syndrome
Scale Clinical
Classification
C13573 PASI PASI01 Psoriasis Area and Severity Index (PASI) (Fredriksson T, Pettersson U. Psoriasis Area and
4 Severe psoriasis--Oral Therapy with a New Retinoid. Dermatologica. Severity Index
1978;157(4):238-244). Clinical
Classification
C13030 QIDS-C QIDSC1 Quick Inventory of Depressive Symptomatology - Clinician-Rated (QIDS-C) Quick Inventory of
9 (Copyright UT Southwestern Medical Center at Dallas. Rush AJ, Trivedi MH, Depressive
Ibrahim HM, Carmody TJ, Arnow B, Klein DN, Markowitz JC, Ninan PT, Symptomatology
Kornstein S, Manber R, Thase ME, Kocsis JH, Keller MB. The 16-item Quick Clinician-Rated
Inventory of Depressive Symptomatology (QIDS) Clinician Rating (QIDS-C) Version Clinical
and Self-Report (QIDS-SR): A psychometric evaluation in patients with Classification
chronic major depression. Biological Psychiatry, 54:573-583, 2003).
C12470 REYNOLDS CVD 10- RCVD01 Reynolds Cardiovascular Disease 10-Year Risk Score (Ridker PM, Buring JE, Reynolds
8 YEAR RISK Rifai N, Cook NR. Development and Validation of Improved Algorithms for Cardiovascular
the Assessment of Global Cardiovascular Risk in Women: The Reynolds Risk Disease 10-Year
Score. Jama 2007; 297: 611-619), (Ridker PM, Paynter NP, Rifai N, Gaziano Risk Score Clinical
JM, Cook NR. C-Reactive Protein and Parental History Improve Global Classification
Cardiovascular Risk Prediction: The Reynolds Risk Score for Men.
Circulation2008; 118(22): 2243-2251).
C12470 TANNER SCALE BOY TANN02 Tanner Scale Boy (Marshall WA, Tanner JM. Variations in pattern of pubertal Tanner Scale Boy
3 changes in boys. Arch Dis Child 1970 Feb;45(239):13-23). Version Clinical
Classification
C12470 TANNER SCALE TANN01 Tanner Scale Girl (Marshall WA, Tanner JM. Variations in pattern of pubertal Tanner Scale Girl
4 GIRL changes in girls. Arch Dis Child 1969 Jun; 44(235): 291-303). Version Clinical
Classification
C11910 TIMI THROMBUS TIMG01 Coronary Thrombus TIMI Grade (TIMI Definitions for Commonly Used Terms Coronary Thrombus
4 GRADE in Clinical Trials. Available at http://www.timi.org/wp- TIMI Grade Clinical
content/uploads/2010/10/TIMI-Definitions.pdf. Accessed November 30, Classification
2013).
C15532 UHDRS 1999 UHDR1 Unified Huntington's Disease Rating Scale '99 (UHDRS 1999) (Huntington Unified Huntington's
4 Study Group. (1996). Unified Huntington's Disease Rating Scale: Reliability Disease Rating
and Consistency. Movement Disorders, 11(2), 136-142). Scale 1999 Version
Clinical
Classification
C14168 VALG VALG01 Veterans Administration Lung Study Group (VALG) (Staging small cell lung Veterans
5 cancer: Veterans Administration Lung Study Group versus International Administration Lung
Association for the Study of Lung Cancer--what limits limited disease? Micke Study Group Clinical
P, Faldum A, Metz T, Beeh K.-M, Bittinger F, Hengstler J.-G, Buhl R, Lung Classification
Cancer 2002;37:271-276).
C13030 VLERS VLERS1 Vignos Lower Extremity Rating Scale (VLERS) (Vignos PJ, Spencer CE, Vignos Lower
5 Archibald KC. (1963) Management of progressive muscular dystrophy in Extremity Rating
childhood.JAMA 184:389-96. Brooke MG, Griggs RC, Mendell JR, Fenichel, Scale Clinical
GM, Shumate JB and Peggegrino RJ (1981). Clinical trial in duchenne Classification
dystrophy. I The Design of the Protocol. Muscle and Nerve: 4:186-197).
C12470 WEST HAVEN WHEG01 West Haven Hepatic Encephalopathy Grade (Blei AT, Cordoba J. Hepatic West Haven Hepatic
9 HEPATIC Encephalopathy. Am J Gastroenterol. 2001 Jul. 96(7):1968-76). Encephalopathy
ENCEPHALOPATHY Grade Clinical
GRADE Classification
C12471 WHO HIV STAGING WHIVS1 WHO Clinical Staging of HIV/AIDS for Adults and Adolescents (Copyright World Health
3 FOR ADULTS AND World Health Organization 2007, World Health Organization. WHO case Organization Clinical
ADOLESCENTS definitions of HIV for surveillance and revised clinical staging and Staging of HIV/AIDS
immunological classification of HIV-related disease in adults and children; for Adults and
2007. Retrieved from http://www.who.int/hiv/pub/vct/hivstaging/en/). Adolescents Clinical
Classification
page 171 of 1925

C1189 CCCAT
71

Code Value Term
C12471 WHO HIV STAGING WHIVS2 WHO Clinical Staging of HIV/AIDS for Children (Copyright World Health World Health
4 FOR CHILDREN Organization 2007, World Health Organization. WHO case definitions of HIV Organization Clinical
for surveillance and revised clinical staging and immunological classification Staging of HIV/AIDS
of HIV-related disease in adults and children; 2007. Retrieved from for Children Clinical
http://www.who.int/hiv/pub/vct/hivstaging/en/). Classification
page 172 of 1925

CCINVTYP (Contact Case Investigation Contact Type)
C102575 CCINVTYP
Code Value
C102606 CASUAL CONTACT A way of contracting a disease through everyday Casual Contact
interactions (nonsexual) with an infected person.
C102609 CONTACT WITH A way of contracting a disease by interacting with an Contact With Exposure
EXPOSURE DURING individual that has been exposed to the disease while During Medical Procedure
MEDICAL PROCEDURE undergoing a medical procedure.
C102610 CONTACT WITH A way of contracting a disease by physically associating Contact With Exposure In
EXPOSURE IN CROWD with an infected group of individuals. Crowd Setting
SETTING
C102611 CONTACT WITH MEDICAL A way of contracting a disease by interacting with an Contact With Medical Risk
RISK FACTOR individual that is considered at high risk for having the Factor
disease.
C102646 HOUSEHOLD CONTACT A way of contracting a disease through interactions with Household Contact
an infected person in the same residence.
page 173 of 1925

CCQ01TC (Clinical COPD Questionnaire 24 Hour Version Questionnaire Test Code)
C119064 CCQ01TC
Code Value
C119122 CCQ0101 CCQ01-Short of Breath at Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Rest average, during the past 24 hours, how often did you Short of Breath at Rest
feel: Short of breath while at rest?
C119123 CCQ0102 CCQ01-Short of Breath Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Physical Activity average, during the past 24 hours, how often did you Short of Breath Doing
feel: Short of breath while doing physical activities? Physical Activity
C119124 CCQ0103 CCQ01-Concern About Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Breathing Get Worse average, during the past 24 hours, how often did you Concern About Breathing
feel: Concerned about getting a cold or your breathing Get Worse
getting worse?
C119125 CCQ0104 CCQ01-Depressed for Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Breathing Problem average, during the past 24 hours, how often did you Depressed Because of
feel: Depressed because of your breathing problems? Breathing Problem
C119126 CCQ0105 CCQ01-Cough Clinical COPD Questionnaire 24 Hour Version - In general, CCQ 24 Hour Version -
during the past 24 hours, how much of the time: Did you Did You Cough
cough?
C119127 CCQ0106 CCQ01-Produce Sputum Clinical COPD Questionnaire 24 Hour Version - In general, CCQ 24 Hour Version -
or Phlegm during the past 24 hours, how much of the time: Did you Produce Sputum or
produce sputum or phlegm? Phlegm
C119128 CCQ0107 CCQ01-Breathing Limit Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Strenuous Activity average, during the past 24 hours, how limited were you Breathing Problems Limit
in these activities because of your breathing problems: Strenuous Activity
Strenuous physical activities?
Moderate Activity average, during the past 24 hours, how limited were you Breathing Problems Limit
in these activities because of your breathing problems: Moderate Activity
Moderate physical activities?
Daily Activity average, during the past 24 hours, how limited were you Breathing Problems Limit
in these activities because of your breathing problems: Daily Activity
Daily activities at home?
Social Activity average, during the past 24 hours, how limited were you Breathing Problems Limit
in these activities because of your breathing problems: Social Activity
Social activities?
page 174 of 1925

CCQ01TN (Clinical COPD Questionnaire 24 Hour Version Questionnaire Test Name)
C119063 CCQ01TN
Code Value
C119130 CCQ01-Breathing Limit CCQ01-Breathing Limit Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Daily Activity Daily Activity average, during the past 24 hours, how limited were you Breathing Problems Limit
in these activities because of your breathing problems: Daily Activity
Daily activities at home?
Moderate Activity Moderate Activity average, during the past 24 hours, how limited were you Breathing Problems Limit
in these activities because of your breathing problems: Moderate Activity
Social Activity Social Activity average, during the past 24 hours, how limited were you Breathing Problems Limit
in these activities because of your breathing problems: Social Activity
Social activities?
Strenuous Activity Strenuous Activity average, during the past 24 hours, how limited were you Breathing Problems Limit
in these activities because of your breathing problems: Strenuous Activity
C119124 CCQ01-Concern About CCQ01-Concern About Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Breathing Get Worse Breathing Get Worse average, during the past 24 hours, how often did you Concern About Breathing
feel: Concerned about getting a cold or your breathing Get Worse
getting worse?
C119126 CCQ01-Cough CCQ01-Cough Clinical COPD Questionnaire 24 Hour Version - In general, CCQ 24 Hour Version -
during the past 24 hours, how much of the time: Did you Did You Cough
cough?
C119125 CCQ01-Depressed for CCQ01-Depressed for Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Breathing Problem Breathing Problem average, during the past 24 hours, how often did you Depressed Because of
feel: Depressed because of your breathing problems? Breathing Problem
C119127 CCQ01-Produce Sputum CCQ01-Produce Sputum Clinical COPD Questionnaire 24 Hour Version - In general, CCQ 24 Hour Version -
or Phlegm or Phlegm during the past 24 hours, how much of the time: Did you Produce Sputum or
C119122 CCQ01-Short of Breath at CCQ01-Short of Breath at Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Rest Rest average, during the past 24 hours, how often did you Short of Breath at Rest
feel: Short of breath while at rest?
C119123 CCQ01-Short of Breath CCQ01-Short of Breath Clinical COPD Questionnaire 24 Hour Version - On CCQ 24 Hour Version -
Physical Activity Physical Activity average, during the past 24 hours, how often did you Short of Breath Doing
feel: Short of breath while doing physical activities? Physical Activity
page 175 of 1925

CCQ02TC (Clinical COPD Questionnaire 1 Week Version Questionnaire Test Code)
C119066 CCQ02TC
Code Value
C119132 CCQ0201 CCQ02-Short of Breath at Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Rest average, during the past 7 days, how often did you feel: Short of Breath at Rest
Short of breath while at rest?
C119133 CCQ0202 CCQ02-Short of Breath Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Physical Activity average, during the past 7 days, how often did you feel: Short of Breath Doing
Short of breath while doing physical activities? Physical Activity
C119134 CCQ0203 CCQ02-Concern About Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Breathing Get Worse average, during the past 7 days, how often did you feel: Concern About Breathing
Concerned about getting a cold or your breathing getting Get Worse
worse?
C119135 CCQ0204 CCQ02-Depressed for Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Breathing Problem average, during the past 7 days, how often did you feel: Depressed Because of
Depressed because of your breathing problems? Breathing Problem
C119136 CCQ0205 CCQ02-Cough Clinical COPD Questionnaire 1 Week Version - In general, CCQ 1 Week Version -
during the past 7 days, how much of the time: Did you Did You Cough
cough?
C119137 CCQ0206 CCQ02-Produce Sputum Clinical COPD Questionnaire 1 Week Version - In general, CCQ 1 Week Version -
or Phlegm during the past 7 days, how much of the time: Did you Produce Sputum or
C119138 CCQ0207 CCQ02-Breathing Limit Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Strenuous Activity average, during the past 7 days, how limited were you in Breathing Problems Limit
these activities because of your breathing problems: Strenuous Activity
Moderate Activity average, during the past 7 days, how limited were you in Breathing Problems Limit
these activities because of your breathing problems: Moderate Activity
Daily Activity average, during the past 7 days, how limited were you in Breathing Problems Limit
these activities because of your breathing problems: Daily Daily Activity
activities at home?
Social Activity average, during the past 7 days, how limited were you in Breathing Problems Limit
these activities because of your breathing problems: Social Activity
Social activities?
page 176 of 1925

CCQ02TN (Clinical COPD Questionnaire 1 Week Version Questionnaire Test Name)
C119065 CCQ02TN
Code Value
C119140 CCQ02-Breathing Limit CCQ02-Breathing Limit Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Daily Activity Daily Activity average, during the past 7 days, how limited were you in Breathing Problems Limit
these activities because of your breathing problems: Daily Daily Activity
activities at home?
Moderate Activity Moderate Activity average, during the past 7 days, how limited were you in Breathing Problems Limit
these activities because of your breathing problems: Moderate Activity
Social Activity Social Activity average, during the past 7 days, how limited were you in Breathing Problems Limit
these activities because of your breathing problems: Social Activity
Social activities?
Strenuous Activity Strenuous Activity average, during the past 7 days, how limited were you in Breathing Problems Limit
these activities because of your breathing problems: Strenuous Activity
C119134 CCQ02-Concern About CCQ02-Concern About Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Breathing Get Worse Breathing Get Worse average, during the past 7 days, how often did you feel: Concern About Breathing
Concerned about getting a cold or your breathing getting Get Worse
worse?
C119136 CCQ02-Cough CCQ02-Cough Clinical COPD Questionnaire 1 Week Version - In general, CCQ 1 Week Version -
during the past 7 days, how much of the time: Did you Did You Cough
cough?
C119135 CCQ02-Depressed for CCQ02-Depressed for Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Breathing Problem Breathing Problem average, during the past 7 days, how often did you feel: Depressed Because of
Depressed because of your breathing problems? Breathing Problem
C119137 CCQ02-Produce Sputum CCQ02-Produce Sputum Clinical COPD Questionnaire 1 Week Version - In general, CCQ 1 Week Version -
or Phlegm or Phlegm during the past 7 days, how much of the time: Did you Produce Sputum or
C119132 CCQ02-Short of Breath at CCQ02-Short of Breath at Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Rest Rest average, during the past 7 days, how often did you feel: Short of Breath at Rest
Short of breath while at rest?
C119133 CCQ02-Short of Breath CCQ02-Short of Breath Clinical COPD Questionnaire 1 Week Version - On CCQ 1 Week Version -
Physical Activity Physical Activity average, during the past 7 days, how often did you feel: Short of Breath Doing
Short of breath while doing physical activities? Physical Activity
page 177 of 1925

CCRCLS (Consensus Cardiac Classification System Test Name)
C101837 CCRCLS
Code Value
C100032 ACC/AHA Lesion ACC/AHA Lesion A classification system for coronary stenosis based upon American College of
Complexity Class Complexity Class characteristics that influence the difficulty of Cardiology/American
percutaneous coronary revascularization. Heart Association Lesion
Complexity Class
C66910 Canadian CV Society Canadian CV Society A finding associated with a patient based on the Canadian Cardiovascular
Grading Scale Grading Scale functional classification developed by the Canadian Society Grading Scale
Cardiovascular Society (CCS), for categorizing patients Class
with angina. The classification system comprises four
classes, which are defined in terms of the level of physical
activity associated with the subject's anginal symptoms.
C66916 Killip Class Killip Class A finding associated with a patient based on the Killip Class
classification developed by Killip and Kimball, which
classifies patients with myocardial infarction based on
routine physical examination parameters, such as the
presence or absence of rales, or a decreased systolic
blood pressure.
C66909 New York Heart New York Heart A finding associated with a patient based on the New York Heart
Association Class Association Class functional classification developed by the New York Heart Association Class
Association (NYHA), for categorizing patients with defined
or presumed cardiac disease. The classification system is
based on the ability to engage in physical activity. The
classification system comprises four classes, though
NYHA Class III and Class IV are often aggregated for the
purpose of outcomes analysis.
C100021 TIMI Flow TIMI Flow A grading system for coronary blood flow based on the Thrombolysis in
classification developed by the Thrombolysis in Myocardial Myocardial Infarction Flow
Infarction Group. It classifies coronary blood flow into
four classes based upon the angiographic appearance of
the blood vessels.
page 178 of 1925

CCRCLSCD (Consensus Cardiac Classification System Test Code)
C101838 CCRCLSCD
Code Value
C66910 CCSGRDS Canadian CV Society A finding associated with a patient based on the Canadian Cardiovascular
Grading Scale functional classification developed by the Canadian Society Grading Scale
Cardiovascular Society (CCS), for categorizing patients Class
with angina. The classification system comprises four
classes, which are defined in terms of the level of physical
activity associated with the subject's anginal symptoms.
C66916 KILLIPCL Killip Class A finding associated with a patient based on the Killip Class
classification developed by Killip and Kimball, which
classifies patients with myocardial infarction based on
routine physical examination parameters, such as the
presence or absence of rales, or a decreased systolic
blood pressure.
C100032 LSNCPCLS ACC/AHA Lesion A classification system for coronary stenosis based upon American College of
Complexity Class characteristics that influence the difficulty of Cardiology/American
percutaneous coronary revascularization. Heart Association Lesion
Complexity Class
C66909 NYHACLS New York Heart A finding associated with a patient based on the New York Heart
Association Class functional classification developed by the New York Heart Association Class
Association (NYHA), for categorizing patients with defined
or presumed cardiac disease. The classification system is
based on the ability to engage in physical activity. The
classification system comprises four classes, though
NYHA Class III and Class IV are often aggregated for the
purpose of outcomes analysis.
C100021 TIMIFLOW TIMI Flow A grading system for coronary blood flow based on the Thrombolysis in
classification developed by the Thrombolysis in Myocardial Myocardial Infarction Flow
Infarction Group. It classifies coronary blood flow into
four classes based upon the angiographic appearance of
the blood vessels.
page 179 of 1925

CDFATS (CDAD Findings About Test Name)
C150813 CDFATS
Code Value
C124281 Number of Episodes Number of Episodes The total number of episodes that have occurred for the Number of Episodes
condition.
C150827 Number of Occurrences Number of Occurrences The number of instances. Number of Occurrences
C25676 Severity/Intensity Severity/Intensity The degree of something undesirable. Severity
C74720 Volume Volume A measurement of the volume of a biological specimen. Volume Measurement
page 180 of 1925

CDFATSCD (CDAD Findings About Test Code)
C150812 CDFATSCD
Code Value
C124281 EPSDNUM Number of Episodes The total number of episodes that have occurred for the Number of Episodes
condition.
C150827 NUMOCCUR Number of Occurrences The number of instances. Number of Occurrences
C25676 SEV Severity/Intensity The degree of something undesirable. Severity
C74720 VOL Volume A measurement of the volume of a biological specimen. Volume Measurement
page 181 of 1925

CDR01TC (Clinical Dementia Rating Questionnaire Test Code)
C101811 CDR01TC
Code Value
C102050 CDR0101 CDR01-Memory Clinical Dementia Rating - Memory. CDR - Memory
C102051 CDR0102 CDR01-Orientation Clinical Dementia Rating - Orientation. CDR - Orientation
C102052 CDR0103 CDR01-Judgment and Clinical Dementia Rating - Judgment and problem solving. CDR - Judgment and
Problem Solving Problem Solving
C102053 CDR0104 CDR01-Community Clinical Dementia Rating - Community affairs. CDR - Community Affairs
Affairs
C102054 CDR0105 CDR01-Home and Clinical Dementia Rating - Home and hobbies. CDR - Home and Hobbies
Hobbies
C102055 CDR0106 CDR01-Personal Care Clinical Dementia Rating - Personal care. CDR - Personal Care
C113880 CDR0107 CDR01-Sum of Boxes Clinical Dementia Rating - Sum of Boxes. CDR - Sum of Boxes
C113881 CDR0108 CDR01-Global CDR Clinical Dementia Rating - Global CDR. CDR - Global CDR
page 182 of 1925

CDR01TN (Clinical Dementia Rating Questionnaire Test Name)
C101812 CDR01TN
Code Value
C102053 CDR01-Community CDR01-Community Clinical Dementia Rating - Community affairs. CDR - Community Affairs
Affairs Affairs
C113881 CDR01-Global CDR CDR01-Global CDR Clinical Dementia Rating - Global CDR. CDR - Global CDR
C102054 CDR01-Home and CDR01-Home and Clinical Dementia Rating - Home and hobbies. CDR - Home and Hobbies
Hobbies Hobbies
C102052 CDR01-Judgment and CDR01-Judgment and Clinical Dementia Rating - Judgment and problem solving. CDR - Judgment and
Problem Solving Problem Solving Problem Solving
C102050 CDR01-Memory CDR01-Memory Clinical Dementia Rating - Memory. CDR - Memory
C102051 CDR01-Orientation CDR01-Orientation Clinical Dementia Rating - Orientation. CDR - Orientation
C102055 CDR01-Personal Care CDR01-Personal Care Clinical Dementia Rating - Personal care. CDR - Personal Care
C113880 CDR01-Sum of Boxes CDR01-Sum of Boxes Clinical Dementia Rating - Sum of Boxes. CDR - Sum of Boxes
page 183 of 1925

CDRS01TC (Children's Depression Rating Scale, Revised Clinical Classification Test Code)
C154447 CDRS01TC
Code Value
C155329 CDRS101 CDRS1-Impaired Children's Depression Rating Scale, Revised - Impaired CDRS-R - Impaired
Schoolwork schoolwork. Schoolwork
C155330 CDRS101A CDRS1-Impaired Children's Depression Rating Scale, Revised - Impaired CDRS-R - Impaired
Schoolwork Comment schoolwork comment. Schoolwork Comment
C155331 CDRS102 CDRS1-Difficulty Having Children's Depression Rating Scale, Revised - Difficulty CDRS-R - Difficulty
Fun having fun. Having Fun
C155332 CDRS102A CDRS1-Difficulty Having Children's Depression Rating Scale, Revised - Difficulty CDRS-R - Difficulty
Fun Comment having fun comment. Having Fun Comment
C155333 CDRS103 CDRS1-Social Withdrawal Children's Depression Rating Scale, Revised - Social CDRS-R - Social
withdrawal. Withdrawal
C155334 CDRS103A CDRS1-Social Withdrawal Children's Depression Rating Scale, Revised - Social CDRS-R - Social
Comment withdrawal comment. Withdrawal Comment
C155335 CDRS104 CDRS1-Sleep Disturbance Children's Depression Rating Scale, Revised - Sleep CDRS-R - Sleep
disturbance. Disturbance
C155336 CDRS104A CDRS1-Sleep Disturbance Children's Depression Rating Scale, Revised - Sleep CDRS-R - Sleep
Comment disturbance comment. Disturbance Comment
C155337 CDRS105 CDRS1-Appetite Children's Depression Rating Scale, Revised - Appetite CDRS-R - Appetite
Disturbance disturbance. Disturbance
C155338 CDRS105A CDRS1-Appetite Children's Depression Rating Scale, Revised - Appetite CDRS-R - Appetite
Disturbance Comment disturbance comment. Disturbance Comment
C155339 CDRS106 CDRS1-Excessive Fatigue Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive
fatigue. Fatigue
C155340 CDRS106A CDRS1-Excessive Fatigue Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive
Comment fatigue comment. Fatigue Comment
C155341 CDRS107 CDRS1-Physical Children's Depression Rating Scale, Revised - Physical CDRS-R - Physical
Complaints complaints. Complaints
C155342 CDRS107A CDRS1-Physical Children's Depression Rating Scale, Revised - Physical CDRS-R - Physical
Complaints Comment complaints comment. Complaints Comment
C155343 CDRS108 CDRS1-Irritability Children's Depression Rating Scale, Revised - Irritability. CDRS-R - Irritability
C155344 CDRS108A CDRS1-Irritability Children's Depression Rating Scale, Revised - Irritability CDRS-R - Irritability
Comment comment. Comment
C155345 CDRS109 CDRS1-Excessive Guilt Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive Guilt
guilt.
C155346 CDRS109A CDRS1-Excessive Guilt Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive Guilt
Comment guilt comment. Comment
C155347 CDRS110 CDRS1-Low Self-esteem Children's Depression Rating Scale, Revised - Low self- CDRS-R - Low Self-
esteem. esteem
C155348 CDRS110A CDRS1-Low Self-esteem Children's Depression Rating Scale, Revised - Low self- CDRS-R - Low Self-
Comment esteem comment. esteem Comment
C155349 CDRS111 CDRS1-Depressed Children's Depression Rating Scale, Revised - Depressed CDRS-R - Depressed
Feelings feelings. Feelings
C155350 CDRS111A CDRS1-Depressed Children's Depression Rating Scale, Revised - Depressed CDRS-R - Depressed
Feelings Comment feelings comment. Feelings Comment
C155351 CDRS112 CDRS1-Morbid Ideation Children's Depression Rating Scale, Revised - Morbid CDRS-R - Morbid Ideation
ideation.
C155352 CDRS112A CDRS1-Morbid Ideation Children's Depression Rating Scale, Revised - Morbid CDRS-R - Morbid Ideation
Comment ideation comment. Comment
C155353 CDRS113 CDRS1-Suicidal Ideation Children's Depression Rating Scale, Revised - Suicidal CDRS-R - Suicidal
ideation. Ideation
C155354 CDRS113A CDRS1-Suicidal Ideation Children's Depression Rating Scale, Revised - Suicidal CDRS-R - Suicidal
Comment ideation comment. Ideation Comment
page 184 of 1925

C154447 CDRS01TC
Code Value
C155355 CDRS114 CDRS1-Excessive Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive
Weeping weeping. Weeping
C155356 CDRS114A CDRS1-Excessive Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive
Weeping Comment weeping comment. Weeping Comment
C155357 CDRS115 CDRS1-Depressed Facial Children's Depression Rating Scale, Revised - Depressed CDRS-R - Depressed
Affect facial affect. Facial Affect
C155358 CDRS115A CDRS1-Depressed Facial Children's Depression Rating Scale, Revised - Depressed CDRS-R - Depressed
Affect Comment facial affect comment. Facial Affect Comment
C155359 CDRS116 CDRS1-Listless Speech Children's Depression Rating Scale, Revised - Listless CDRS-R - Listless Speech
speech.
C155360 CDRS116A CDRS1-Listless Speech Children's Depression Rating Scale, Revised - Listless CDRS-R - Listless Speech
Comment speech comment. Comment
C155361 CDRS117 CDRS1-Hypoactivity Children's Depression Rating Scale, Revised - CDRS-R - Hypoactivity
Hypoactivity.
C155362 CDRS117A CDRS1-Hypoactivity Children's Depression Rating Scale, Revised - CDRS-R - Hypoactivity
Comment Hypoactivity comment. Comment
C155363 CDRS118 CDRS1-Subtotal 1 Children's Depression Rating Scale, Revised - Subtotal 1 - CDRS-R - Subtotal 1
sum of questions 1 to 6.
C155366 CDRS121 CDRS1-CDRS-R Raw Children's Depression Rating Scale, Revised - CDRS-R CDRS-R - CDRS-R Raw
Summary Score raw summary score. Summary Score
C155367 CDRS122 CDRS1-CDRS-R T-Score Children's Depression Rating Scale, Revised - CDRS-R T- CDRS-R - CDRS-R T-
score. Score
C155368 CDRS123 CDRS1-CDRS-R Percentile Children's Depression Rating Scale, Revised - CDRS-R CDRS-R - CDRS-R
Percentile. Percentile
C155369 CDRS124 CDRS1-CDRS-R T-Score Children's Depression Rating Scale, Revised - CDRS-R T- CDRS-R - CDRS-R T-
Range score range. Score Range
page 185 of 1925

CDRS01TN (Children's Depression Rating Scale, Revised Clinical Classification Test Name)
C154446 CDRS01TN
Code Value
C155337 CDRS1-Appetite CDRS1-Appetite Children's Depression Rating Scale, Revised - Appetite CDRS-R - Appetite
Disturbance Disturbance disturbance. Disturbance
C155338 CDRS1-Appetite CDRS1-Appetite Children's Depression Rating Scale, Revised - Appetite CDRS-R - Appetite
Disturbance Comment Disturbance Comment disturbance comment. Disturbance Comment
C155368 CDRS1-CDRS-R Percentile CDRS1-CDRS-R Percentile Children's Depression Rating Scale, Revised - CDRS-R CDRS-R - CDRS-R
Percentile. Percentile
C155366 CDRS1-CDRS-R Raw CDRS1-CDRS-R Raw Children's Depression Rating Scale, Revised - CDRS-R CDRS-R - CDRS-R Raw
Summary Score Summary Score raw summary score. Summary Score
C155367 CDRS1-CDRS-R T-Score CDRS1-CDRS-R T-Score Children's Depression Rating Scale, Revised - CDRS-R T- CDRS-R - CDRS-R T-
score. Score
C155369 CDRS1-CDRS-R T-Score CDRS1-CDRS-R T-Score Children's Depression Rating Scale, Revised - CDRS-R T- CDRS-R - CDRS-R T-
Range Range score range. Score Range
C155357 CDRS1-Depressed Facial CDRS1-Depressed Facial Children's Depression Rating Scale, Revised - Depressed CDRS-R - Depressed
Affect Affect facial affect. Facial Affect
C155358 CDRS1-Depressed Facial CDRS1-Depressed Facial Children's Depression Rating Scale, Revised - Depressed CDRS-R - Depressed
Affect Comment Affect Comment facial affect comment. Facial Affect Comment
C155349 CDRS1-Depressed CDRS1-Depressed Children's Depression Rating Scale, Revised - Depressed CDRS-R - Depressed
Feelings Feelings feelings. Feelings
C155350 CDRS1-Depressed CDRS1-Depressed Children's Depression Rating Scale, Revised - Depressed CDRS-R - Depressed
Feelings Comment Feelings Comment feelings comment. Feelings Comment
C155331 CDRS1-Difficulty Having CDRS1-Difficulty Having Children's Depression Rating Scale, Revised - Difficulty CDRS-R - Difficulty
Fun Fun having fun. Having Fun
C155332 CDRS1-Difficulty Having CDRS1-Difficulty Having Children's Depression Rating Scale, Revised - Difficulty CDRS-R - Difficulty
Fun Comment Fun Comment having fun comment. Having Fun Comment
C155339 CDRS1-Excessive Fatigue CDRS1-Excessive Fatigue Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive
fatigue. Fatigue
C155340 CDRS1-Excessive Fatigue CDRS1-Excessive Fatigue Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive
Comment Comment fatigue comment. Fatigue Comment
C155345 CDRS1-Excessive Guilt CDRS1-Excessive Guilt Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive Guilt
guilt.
C155346 CDRS1-Excessive Guilt CDRS1-Excessive Guilt Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive Guilt
Comment Comment guilt comment. Comment
C155355 CDRS1-Excessive CDRS1-Excessive Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive
Weeping Weeping weeping. Weeping
C155356 CDRS1-Excessive CDRS1-Excessive Children's Depression Rating Scale, Revised - Excessive CDRS-R - Excessive
Weeping Comment Weeping Comment weeping comment. Weeping Comment
C155361 CDRS1-Hypoactivity CDRS1-Hypoactivity Children's Depression Rating Scale, Revised - CDRS-R - Hypoactivity
Hypoactivity.
C155362 CDRS1-Hypoactivity CDRS1-Hypoactivity Children's Depression Rating Scale, Revised - CDRS-R - Hypoactivity
Comment Comment Hypoactivity comment. Comment
C155329 CDRS1-Impaired CDRS1-Impaired Children's Depression Rating Scale, Revised - Impaired CDRS-R - Impaired
Schoolwork Schoolwork schoolwork. Schoolwork
C155330 CDRS1-Impaired CDRS1-Impaired Children's Depression Rating Scale, Revised - Impaired CDRS-R - Impaired
Schoolwork Comment Schoolwork Comment schoolwork comment. Schoolwork Comment
C155343 CDRS1-Irritability CDRS1-Irritability Children's Depression Rating Scale, Revised - Irritability. CDRS-R - Irritability
C155344 CDRS1-Irritability CDRS1-Irritability Children's Depression Rating Scale, Revised - Irritability CDRS-R - Irritability
Comment Comment comment. Comment
C155359 CDRS1-Listless Speech CDRS1-Listless Speech Children's Depression Rating Scale, Revised - Listless CDRS-R - Listless Speech
speech.
C155360 CDRS1-Listless Speech CDRS1-Listless Speech Children's Depression Rating Scale, Revised - Listless CDRS-R - Listless Speech
Comment Comment speech comment. Comment
page 186 of 1925

C154446 CDRS01TN
Code Value
C155347 CDRS1-Low Self-esteem CDRS1-Low Self-esteem Children's Depression Rating Scale, Revised - Low self- CDRS-R - Low Self-
esteem. esteem
C155348 CDRS1-Low Self-esteem CDRS1-Low Self-esteem Children's Depression Rating Scale, Revised - Low self- CDRS-R - Low Self-
Comment Comment esteem comment. esteem Comment
C155351 CDRS1-Morbid Ideation CDRS1-Morbid Ideation Children's Depression Rating Scale, Revised - Morbid CDRS-R - Morbid Ideation
ideation.
C155352 CDRS1-Morbid Ideation CDRS1-Morbid Ideation Children's Depression Rating Scale, Revised - Morbid CDRS-R - Morbid Ideation
Comment Comment ideation comment. Comment
C155341 CDRS1-Physical CDRS1-Physical Children's Depression Rating Scale, Revised - Physical CDRS-R - Physical
Complaints Complaints complaints. Complaints
C155342 CDRS1-Physical CDRS1-Physical Children's Depression Rating Scale, Revised - Physical CDRS-R - Physical
Complaints Comment Complaints Comment complaints comment. Complaints Comment
C155335 CDRS1-Sleep Disturbance CDRS1-Sleep Disturbance Children's Depression Rating Scale, Revised - Sleep CDRS-R - Sleep
disturbance. Disturbance
C155336 CDRS1-Sleep Disturbance CDRS1-Sleep Disturbance Children's Depression Rating Scale, Revised - Sleep CDRS-R - Sleep
Comment Comment disturbance comment. Disturbance Comment
C155333 CDRS1-Social Withdrawal CDRS1-Social Withdrawal Children's Depression Rating Scale, Revised - Social CDRS-R - Social
withdrawal. Withdrawal
C155334 CDRS1-Social Withdrawal CDRS1-Social Withdrawal Children's Depression Rating Scale, Revised - Social CDRS-R - Social
Comment Comment withdrawal comment. Withdrawal Comment
C155363 CDRS1-Subtotal 1 CDRS1-Subtotal 1 Children's Depression Rating Scale, Revised - Subtotal 1 - CDRS-R - Subtotal 1
C155353 CDRS1-Suicidal Ideation CDRS1-Suicidal Ideation Children's Depression Rating Scale, Revised - Suicidal CDRS-R - Suicidal
ideation. Ideation
C155354 CDRS1-Suicidal Ideation CDRS1-Suicidal Ideation Children's Depression Rating Scale, Revised - Suicidal CDRS-R - Suicidal
Comment Comment ideation comment. Ideation Comment
page 187 of 1925

CES01TC (Combat Exposure Scale Questionnaire Test Code)
C132519 CES01TC
Code Value
C132556 CES0101 CES01-Ever Combat Combat Exposure Scale - Did you ever go on combat CES - Ever Combat
Patrols/Dangerous Duty patrols or have other dangerous duty? Patrols or Dangerous
Duty
C132557 CES0102 CES01-Were You Ever Combat Exposure Scale - Were you ever under enemy CES - Were You Ever
Under Enemy Fire fire? Under Enemy Fire
C132558 CES0103 CES01-Ever Surrounded Combat Exposure Scale - Were you ever surrounded by CES - Ever Surrounded
by the Enemy the enemy? by the Enemy
C132559 CES0104 CES01-Soldiers in Unit Combat Exposure Scale - What percentage of the soldiers CES - Soldiers in Unit
KIA, Wounded, MIA in your unit were killed (KIA), wounded or missing in Killed (KIA), Wounded,
action (MIA)? Missing (MIA)
C132560 CES0105 CES01-How Often Fire Combat Exposure Scale - How often did you fire rounds at CES - How Often Fire
Rounds at Enemy the enemy? Rounds at Enemy
C132561 CES0106 CES01-See Someone Hit Combat Exposure Scale - How often did you see someone CES - See Someone Hit
by Rounds hit by incoming or outgoing rounds? by Rounds
C132562 CES0107 CES01-In Danger of Combat Exposure Scale - How often were you in danger CES - In Danger of Being
Being Injured/Killed of being injured or killed (i.e., being pinned down, Injured or Killed
overrun, ambushed, near miss, etc.)?
page 188 of 1925

CES01TN (Combat Exposure Scale Questionnaire Test Name)
C132518 CES01TN
Code Value
C132556 CES01-Ever Combat CES01-Ever Combat Combat Exposure Scale - Did you ever go on combat CES - Ever Combat
Patrols/Dangerous Duty Patrols/Dangerous Duty patrols or have other dangerous duty? Patrols or Dangerous
Duty
C132558 CES01-Ever Surrounded CES01-Ever Surrounded Combat Exposure Scale - Were you ever surrounded by CES - Ever Surrounded
by the Enemy by the Enemy the enemy? by the Enemy
C132560 CES01-How Often Fire CES01-How Often Fire Combat Exposure Scale - How often did you fire rounds at CES - How Often Fire
Rounds at Enemy Rounds at Enemy the enemy? Rounds at Enemy
C132562 CES01-In Danger of CES01-In Danger of Combat Exposure Scale - How often were you in danger CES - In Danger of Being
Being Injured/Killed Being Injured/Killed of being injured or killed (i.e., being pinned down, Injured or Killed
overrun, ambushed, near miss, etc.)?
C132561 CES01-See Someone Hit CES01-See Someone Hit Combat Exposure Scale - How often did you see someone CES - See Someone Hit
by Rounds by Rounds hit by incoming or outgoing rounds? by Rounds
C132559 CES01-Soldiers in Unit CES01-Soldiers in Unit Combat Exposure Scale - What percentage of the soldiers CES - Soldiers in Unit
KIA, Wounded, MIA KIA, Wounded, MIA in your unit were killed (KIA), wounded or missing in Killed (KIA), Wounded,
action (MIA)? Missing (MIA)
C132557 CES01-Were You Ever CES01-Were You Ever Combat Exposure Scale - Were you ever under enemy CES - Were You Ever
Under Enemy Fire Under Enemy Fire fire? Under Enemy Fire
page 189 of 1925

CGGUY1TC (Clinical Global Impression Questionnaire Test Code)
C135684 CGGUY1TC
Code Value
C135811 CGGUY101 CGGUY1-Severity of Clinical Global Impression Guy - Considering your total CGI Original Version -
Illness clinical experience with this particular population, how Severity of Illness
mentally ill is the patient at this time?
C135812 CGGUY102 CGGUY1-Global Clinical Global Impression Guy - Rate total improvement CGI Original Version -
Improvement whether or not, in your judgement, it is due entirely to Global Improvement
drug treatment. Compared to his condition at admission
to the project, how much has he changed?
C135813 CGGUY103 CGGUY1-Efficacy Index Clinical Global Impression Guy - Rate this item on the CGI Original Version -
basis of drug effect only. Select the terms which best Efficacy Index
describe the degrees of therapeutic effect and side
effects.
page 190 of 1925

CGGUY1TN (Clinical Global Impression Questionnaire Test Name)
C135683 CGGUY1TN
Code Value
C135813 CGGUY1-Efficacy Index CGGUY1-Efficacy Index Clinical Global Impression Guy - Rate this item on the CGI Original Version -
basis of drug effect only. Select the terms which best Efficacy Index
describe the degrees of therapeutic effect and side
effects.
C135812 CGGUY1-Global CGGUY1-Global Clinical Global Impression Guy - Rate total improvement CGI Original Version -
Improvement Improvement whether or not, in your judgement, it is due entirely to Global Improvement
drug treatment. Compared to his condition at admission
to the project, how much has he changed?
C135811 CGGUY1-Severity of CGGUY1-Severity of Clinical Global Impression Guy - Considering your total CGI Original Version -
Illness Illness clinical experience with this particular population, how Severity of Illness
mentally ill is the patient at this time?
page 191 of 1925

CGI02TC (Clinical Global Impression Generic Modification Version Questionnaire Test Code)
C135686 CGI02TC
Code Value
C135814 CGI0201 CGI02-Severity Clinical Global Impression - Considering your total clinical CGI Generic Modification
experience with this particular population, how severe is Version - Severity
the subject's condition at this time?
C135815 CGI0202 CGI02-Change Clinical Global Impression - Rate total change whether or CGI Generic Modification
not, in your judgement, it is due entirely to drug Version - Change
treatment. Compared to the subject's condition <at
previously assessed protocol specified time point>, how
much has the subject changed?
C135816 CGI0203 CGI02-Improvement Clinical Global Impression - Rate total improvement CGI Generic Modification
whether or not, in your judgement, it is due entirely to Version - Improvement
drug treatment. Compared to the subject's condition <at
much has the subject improved?
page 192 of 1925

CGI02TN (Clinical Global Impression Generic Modification Version Questionnaire Test Name)
C135685 CGI02TN
Code Value
C135815 CGI02-Change CGI02-Change Clinical Global Impression - Rate total change whether or CGI Generic Modification
not, in your judgement, it is due entirely to drug Version - Change
treatment. Compared to the subject's condition <at
much has the subject changed?
C135816 CGI02-Improvement CGI02-Improvement Clinical Global Impression - Rate total improvement CGI Generic Modification
whether or not, in your judgement, it is due entirely to Version - Improvement
drug treatment. Compared to the subject's condition <at
much has the subject improved?
C135814 CGI02-Severity CGI02-Severity Clinical Global Impression - Considering your total clinical CGI Generic Modification
experience with this particular population, how severe is Version - Severity
the subject's condition at this time?
page 193 of 1925

CHIVC1TC (CDC Classification System for HIV-Infected Adults and Adolescents Clinical Classification
Test Code)
C124678 CHIVC1TC
Code Value
C124779 CHIVC101 CHIVC1-CDC HIV CDC Classification System for HIV-Infected Adults and CDC Classification System
Infection Category Adolescents - CDC HIV infection category. for HIV-Infected Adults
and Adolescents - CDC
HIV Infection Category
page 194 of 1925

CHIVC1TN (CDC Classification System for HIV-Infected Adults and Adolescents Clinical Classification
Test Name)
C124677 CHIVC1TN
Code Value
C124779 CHIVC1-CDC HIV CHIVC1-CDC HIV CDC Classification System for HIV-Infected Adults and CDC Classification System
Infection Category Infection Category Adolescents - CDC HIV infection category. for HIV-Infected Adults
and Adolescents - CDC
HIV Infection Category
page 195 of 1925

CHSF1TC (Craig Handicap Assessment and Reporting Technique - Short Form Interview Version
C117987 CHSF1TC
Code Value
C117998 CHSF101A CHSF1-Paid Personal Care Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
per Day Short Form Interview Version - How many hours in a Version - Paid Personal
typical 24-hour day do you have someone with you to Care per Day
provide physical assistance for personal care activities
such as eating, bathing, dressing, toileting and mobility?
(hours paid assistance).
C117999 CHSF101B CHSF1-Unpaid Personal Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Care per Day Short Form Interview Version - How many hours in a Version - Unpaid Personal
hours unpaid (family, others).
C118000 CHSF102 CHSF1-Home Cognitive Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Assistance per Day Short Form Interview Version - How much time is Version - Cognitive
someone with you in your home to assist you with Assistance at Home per
activities that require remembering, decision making, or Day
judgment?
C118001 CHSF103 CHSF1-Away Cognitive Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Assistance per Day Short Form Interview Version - How much of the time is Version - Cognitive
someone with you to help you with remembering, Assistance Away From
decision making, or judgment when you go away from Home per Day
your home?
C118002 CHSF104 CHSF1-Hours Out of Bed Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
per Day Short Form Interview Version - On a typical day, how Version - Hours Out of
many hours are you out of bed? Bed per Day
C118003 CHSF105 CHSF1-Days Out of the Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
House per Week Short Form Interview Version - In a typical week, how Version - Days Out of the
many days do you get out of your house and go House per Week
somewhere?
C118004 CHSF106 CHSF1-Nights Away From Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Home Last Year Short Form Interview Version - In the last year, how Version - Nights Away
many nights have you spent away from your home? From Home Last Year
C118005 CHSF107A CHSF1-Hours of Paid Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Work per Week Short Form Interview Version - How many hours per Version - Hours of Paid
week do you spend working in a job for which you get Work per Week
paid?
C118006 CHSF107B CHSF1-Occupation of Paid Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Work Short Form Interview Version - How many hours per Version - Occupation of
week do you spend working in a job for which you get Paid Work
paid? (occupation).
C118007 CHSF108 CHSF1-Hours of Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Schoolwork per Week Short Form Interview Version - How many hours per Version - Hours of
week do you spend in school working toward a degree or Schoolwork per Week
in an accredited technical training program?
Homemaking per Week Short Form Interview Version - How many hours per Version - Hours of
week do you spend in active homemaking including Homemaking per Week
parenting, housekeeping, and food preparation?
C118009 CHSF110 CHSF1-Hours of Home Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Maintenance per Week Short Form Interview Version - How many hours per Version - Hours of Home
week do you spend in home maintenance activities such Maintenance per Week
as gardening, house repairs or home improvement?
Recreation per Week Short Form Interview Version - How many hours per Version - Hours of
week do you spend in recreational activities such as Recreational Activities per
sports, exercise, playing cards, or going to movies? Week
C118011 CHSF112 CHSF1-Number of People Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
You Live With Short Form Interview Version - How many people do you Version - Number of
live with? People You Live With
C118012 CHSF113 CHSF1-Live With Spouse Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
or Signif Other Short Form Interview Version - Is one of them your Version - Live With
spouse or significant other? Spouse or Significant
Other
page 196 of 1925

C117987 CHSF1TC
Code Value
C118013 CHSF114 CHSF1-Number of Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Relatives You Live With Short Form Interview Version - Of the people you live Version - Number of
with how many are relatives? Relatives You Live With
C118014 CHSF115 CHSF1-Associates Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Contacted per Month Short Form Interview Version - How many business or Version - Associates
organizational associates do you visit, phone, or write to Contacted per Month
at least once a month?
C118015 CHSF116 CHSF1-Friends Contacted Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
per Month Short Form Interview Version - How many friends do you Version - Friends
visit, phone, or write to at least once a month? Contacted per Month
C118016 CHSF117 CHSF1-Strangers Spoke Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
with Last Month Short Form Interview Version - With how many strangers Version - Initiated
have you initiated a conversation in the last month? Conversation With
Strangers Last Month
C118017 CHSF118 CHSF1-Combined Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Household Income Last Yr Short Form Interview Version - Approximately what was Version - Combined
the combined annual income, in the last year, of all Annual Household Income
family members in your household? Last Year
C118018 CHSF119 CHSF1-Medical Care Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Expenses Last Year Short Form Interview Version - Approximately how much Version - Medical Care
did you pay last year for medical care expenses? Expense Last Year
page 197 of 1925

CHSF1TN (Craig Handicap Assessment and Reporting Technique - Short Form Interview Version
C117986 CHSF1TN
Code Value
C118014 CHSF1-Associates CHSF1-Associates Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Contacted per Month Contacted per Month Short Form Interview Version - How many business or Version - Associates
organizational associates do you visit, phone, or write to Contacted per Month
C118001 CHSF1-Away Cognitive CHSF1-Away Cognitive Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Assistance per Day Assistance per Day Short Form Interview Version - How much of the time is Version - Cognitive
someone with you to help you with remembering, Assistance Away From
decision making, or judgment when you go away from Home per Day
your home?
C118017 CHSF1-Combined CHSF1-Combined Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Household Income Last Yr Household Income Last Yr Short Form Interview Version - Approximately what was Version - Combined
the combined annual income, in the last year, of all Annual Household Income
family members in your household? Last Year
C118003 CHSF1-Days Out of the CHSF1-Days Out of the Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
House per Week House per Week Short Form Interview Version - In a typical week, how Version - Days Out of the
many days do you get out of your house and go House per Week
somewhere?
C118015 CHSF1-Friends Contacted CHSF1-Friends Contacted Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
per Month per Month Short Form Interview Version - How many friends do you Version - Friends
visit, phone, or write to at least once a month? Contacted per Month
C118000 CHSF1-Home Cognitive CHSF1-Home Cognitive Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Assistance per Day Assistance per Day Short Form Interview Version - How much time is Version - Cognitive
someone with you in your home to assist you with Assistance at Home per
activities that require remembering, decision making, or Day
judgment?
C118009 CHSF1-Hours of Home CHSF1-Hours of Home Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Maintenance per Week Maintenance per Week Short Form Interview Version - How many hours per Version - Hours of Home
week do you spend in home maintenance activities such Maintenance per Week
as gardening, house repairs or home improvement?
C118008 CHSF1-Hours of CHSF1-Hours of Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Homemaking per Week Homemaking per Week Short Form Interview Version - How many hours per Version - Hours of
week do you spend in active homemaking including Homemaking per Week
parenting, housekeeping, and food preparation?
C118005 CHSF1-Hours of Paid CHSF1-Hours of Paid Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Work per Week Work per Week Short Form Interview Version - How many hours per Version - Hours of Paid
week do you spend working in a job for which you get Work per Week
paid?
Recreation per Week Recreation per Week Short Form Interview Version - How many hours per Version - Hours of
week do you spend in recreational activities such as Recreational Activities per
sports, exercise, playing cards, or going to movies? Week
Schoolwork per Week Schoolwork per Week Short Form Interview Version - How many hours per Version - Hours of
week do you spend in school working toward a degree or Schoolwork per Week
in an accredited technical training program?
C118002 CHSF1-Hours Out of Bed CHSF1-Hours Out of Bed Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
per Day per Day Short Form Interview Version - On a typical day, how Version - Hours Out of
many hours are you out of bed? Bed per Day
C118012 CHSF1-Live With Spouse CHSF1-Live With Spouse Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
or Signif Other or Signif Other Short Form Interview Version - Is one of them your Version - Live With
spouse or significant other? Spouse or Significant
Other
C118018 CHSF1-Medical Care CHSF1-Medical Care Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Expenses Last Year Expenses Last Year Short Form Interview Version - Approximately how much Version - Medical Care
did you pay last year for medical care expenses? Expense Last Year
C118004 CHSF1-Nights Away From CHSF1-Nights Away From Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Home Last Year Home Last Year Short Form Interview Version - In the last year, how Version - Nights Away
many nights have you spent away from your home? From Home Last Year
C118011 CHSF1-Number of People CHSF1-Number of People Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
You Live With You Live With Short Form Interview Version - How many people do you Version - Number of
live with? People You Live With
page 198 of 1925

C117986 CHSF1TN
Code Value
C118013 CHSF1-Number of CHSF1-Number of Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Relatives You Live With Relatives You Live With Short Form Interview Version - Of the people you live Version - Number of
with how many are relatives? Relatives You Live With
C118006 CHSF1-Occupation of Paid CHSF1-Occupation of Paid Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Work Work Short Form Interview Version - How many hours per Version - Occupation of
week do you spend working in a job for which you get Paid Work
paid? (occupation).
C117998 CHSF1-Paid Personal Care CHSF1-Paid Personal Care Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
per Day per Day Short Form Interview Version - How many hours in a Version - Paid Personal
(hours paid assistance).
C118016 CHSF1-Strangers Spoke CHSF1-Strangers Spoke Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
with Last Month with Last Month Short Form Interview Version - With how many strangers Version - Initiated
have you initiated a conversation in the last month? Conversation With
Strangers Last Month
C117999 CHSF1-Unpaid Personal CHSF1-Unpaid Personal Craig Handicap Assessment and Reporting Technique- CHART-SF Interview
Care per Day Care per Day Short Form Interview Version - How many hours in a Version - Unpaid Personal
hours unpaid (family, others).
page 199 of 1925

CHSF2TC (Craig Handicap Assessment and Reporting Technique - Short Form Paper Version
C119068 CHSF2TC
Code Value
C119142 CHSF201A CHSF2-Paid Personal Care Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
per Day Short Form Paper Version - How many hours in a typical - Paid Personal Care per
24-hour day do you have someone with you to provide Day
physical assistance for personal care activities such as
eating, bathing, dressing, toileting and mobility? (hours
paid assistance).
C119143 CHSF201B CHSF2-Unpaid Personal Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Care per Day Short Form Paper Version - How many hours in a typical - Unpaid Personal Care
24-hour day do you have someone with you to provide per Day
eating, bathing, dressing, toileting and mobility? hours
unpaid (family, others).
C119144 CHSF202 CHSF2-Home Cognitive Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Assistance per Day Short Form Paper Version - How much time is someone - Cognitive Assistance at
with you in your home to assist you with activities that Home per Day
require remembering, decision making, or judgment?
C119145 CHSF203 CHSF2-Away Cognitive Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Assistance per Day Short Form Paper Version - How much of the time is - Cognitive Assistance
someone with you to help you with remembering, Away From Home per
decision making, or judgment when you go away from Day
your home?
C119146 CHSF204 CHSF2-Hours Out of Bed Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
per Day Short Form Paper Version - On a typical day, how many - Hours Out of Bed per
hours are you out of bed? Day
C119147 CHSF205 CHSF2-Days Out of the Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
House per Week Short Form Paper Version - In a typical week, how many - Days Out of the House
days do you get out of your house and go somewhere? per Week
C119148 CHSF206 CHSF2-Nights Away From Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Home Last Year Short Form Paper Version - In the last year, how many - Nights Away From
nights have you spent away from your home? Home Last Year
C119149 CHSF207A CHSF2-Hours of Paid Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Work per Week Short Form Paper Version - How many hours per week do - Hours of Paid Work per
you spend working in a job for which you get paid? Week
C119150 CHSF207B CHSF2-Occupation of Paid Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Work Short Form Paper Version - How many hours per week do - Occupation of Paid Work
you spend working in a job for which you get paid?
(occupation).
C119151 CHSF208 CHSF2-Hours of Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Schoolwork per Week Short Form Paper Version - How many hours per week do - Hours of Schoolwork per
you spend in school working toward a degree or in an Week
accredited technical training program?
Homemaking per Week Short Form Paper Version - How many hours per week do - Hours of Homemaking
you spend in active homemaking including parenting, per Week
housekeeping, and food preparation?
C119153 CHSF210 CHSF2-Hours of Home Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Maintenance per Week Short Form Paper Version - How many hours per week do - Hours of Home
you spend in home maintenance activities such as Maintenance per Week
gardening, house repairs or home improvement?
Recreation per Week Short Form Paper Version - How many hours per week do - Hours of Recreational
you spend in recreational activities such as sports, Activities per Week
exercise, playing cards, or going to movies?
C119155 CHSF212 CHSF2-Number of People Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
You Live With Short Form Paper Version - How many people do you live - Number of People You
with? Live With
C119156 CHSF213 CHSF2-Live With Spouse Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
or Signif Other Short Form Paper Version - Is one of them your spouse or - Live With Spouse or
significant other? Significant Other
C119157 CHSF214 CHSF2-Number of Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Relatives You Live With Short Form Paper Version - Of the people you live with - Number of Relatives
how many are relatives? You Live With
page 200 of 1925

C119068 CHSF2TC
Code Value
C119158 CHSF215 CHSF2-Associates Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Contacted per Month Short Form Paper Version - How many business or - Associates Contacted
organizational associates do you visit, phone, or write to per Month
C119159 CHSF216 CHSF2-Friends Contacted Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
per Month Short Form Paper Version - How many friends do you - Friends Contacted per
visit, phone, or write to at least once a month? Month
C119160 CHSF217 CHSF2-Strangers Spoke Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
with Last Month Short Form Paper Version - With how many strangers - Initiated Conversation
have you initiated a conversation in the last month? With Strangers Last
Month
C119161 CHSF218 CHSF2-Combined Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Household Income Last Yr Short Form Paper Version - Approximately what was the - Combined Annual
combined annual income, in the last year, of all family Household Income Last
members in your household? Year
C119162 CHSF219 CHSF2-Medical Care Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Expenses Last Year Short Form Paper Version - Approximately how much did - Medical Care Expense
you pay last year for medical care expenses? Last Year
page 201 of 1925

CHSF2TN (Craig Handicap Assessment and Reporting Technique - Short Form Paper Version
C119067 CHSF2TN
Code Value
C119158 CHSF2-Associates CHSF2-Associates Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Contacted per Month Contacted per Month Short Form Paper Version - How many business or - Associates Contacted
organizational associates do you visit, phone, or write to per Month
C119145 CHSF2-Away Cognitive CHSF2-Away Cognitive Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Assistance per Day Assistance per Day Short Form Paper Version - How much of the time is - Cognitive Assistance
someone with you to help you with remembering, Away From Home per
decision making, or judgment when you go away from Day
your home?
C119161 CHSF2-Combined CHSF2-Combined Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Household Income Last Yr Household Income Last Yr Short Form Paper Version - Approximately what was the - Combined Annual
combined annual income, in the last year, of all family Household Income Last
members in your household? Year
C119147 CHSF2-Days Out of the CHSF2-Days Out of the Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
House per Week House per Week Short Form Paper Version - In a typical week, how many - Days Out of the House
days do you get out of your house and go somewhere? per Week
C119159 CHSF2-Friends Contacted CHSF2-Friends Contacted Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
per Month per Month Short Form Paper Version - How many friends do you - Friends Contacted per
visit, phone, or write to at least once a month? Month
C119144 CHSF2-Home Cognitive CHSF2-Home Cognitive Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Assistance per Day Assistance per Day Short Form Paper Version - How much time is someone - Cognitive Assistance at
with you in your home to assist you with activities that Home per Day
require remembering, decision making, or judgment?
C119153 CHSF2-Hours of Home CHSF2-Hours of Home Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Maintenance per Week Maintenance per Week Short Form Paper Version - How many hours per week do - Hours of Home
you spend in home maintenance activities such as Maintenance per Week
gardening, house repairs or home improvement?
C119152 CHSF2-Hours of CHSF2-Hours of Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Homemaking per Week Homemaking per Week Short Form Paper Version - How many hours per week do - Hours of Homemaking
you spend in active homemaking including parenting, per Week
housekeeping, and food preparation?
C119149 CHSF2-Hours of Paid CHSF2-Hours of Paid Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Work per Week Work per Week Short Form Paper Version - How many hours per week do - Hours of Paid Work per
you spend working in a job for which you get paid? Week
Recreation per Week Recreation per Week Short Form Paper Version - How many hours per week do - Hours of Recreational
you spend in recreational activities such as sports, Activities per Week
exercise, playing cards, or going to movies?
Schoolwork per Week Schoolwork per Week Short Form Paper Version - How many hours per week do - Hours of Schoolwork per
you spend in school working toward a degree or in an Week
accredited technical training program?
C119146 CHSF2-Hours Out of Bed CHSF2-Hours Out of Bed Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
per Day per Day Short Form Paper Version - On a typical day, how many - Hours Out of Bed per
hours are you out of bed? Day
C119156 CHSF2-Live With Spouse CHSF2-Live With Spouse Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
or Signif Other or Signif Other Short Form Paper Version - Is one of them your spouse or - Live With Spouse or
significant other? Significant Other
C119162 CHSF2-Medical Care CHSF2-Medical Care Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Expenses Last Year Expenses Last Year Short Form Paper Version - Approximately how much did - Medical Care Expense
you pay last year for medical care expenses? Last Year
C119148 CHSF2-Nights Away From CHSF2-Nights Away From Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Home Last Year Home Last Year Short Form Paper Version - In the last year, how many - Nights Away From
nights have you spent away from your home? Home Last Year
C119155 CHSF2-Number of People CHSF2-Number of People Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
You Live With You Live With Short Form Paper Version - How many people do you live - Number of People You
with? Live With
C119157 CHSF2-Number of CHSF2-Number of Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Relatives You Live With Relatives You Live With Short Form Paper Version - Of the people you live with - Number of Relatives
how many are relatives? You Live With
page 202 of 1925

C119067 CHSF2TN
Code Value
C119150 CHSF2-Occupation of Paid CHSF2-Occupation of Paid Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Work Work Short Form Paper Version - How many hours per week do - Occupation of Paid Work
you spend working in a job for which you get paid?
(occupation).
C119142 CHSF2-Paid Personal Care CHSF2-Paid Personal Care Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
per Day per Day Short Form Paper Version - How many hours in a typical - Paid Personal Care per
24-hour day do you have someone with you to provide Day
eating, bathing, dressing, toileting and mobility? (hours
paid assistance).
C119160 CHSF2-Strangers Spoke CHSF2-Strangers Spoke Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
with Last Month with Last Month Short Form Paper Version - With how many strangers - Initiated Conversation
have you initiated a conversation in the last month? With Strangers Last
Month
C119143 CHSF2-Unpaid Personal CHSF2-Unpaid Personal Craig Handicap Assessment and Reporting Technique- CHART-SF Paper Version
Care per Day Care per Day Short Form Paper Version - How many hours in a typical - Unpaid Personal Care
24-hour day do you have someone with you to provide per Day
eating, bathing, dressing, toileting and mobility? hours
unpaid (family, others).
page 203 of 1925

CLMETH (Specimen Collection Method)
C132314 CLMETH
Code Value
C15189 BIOPSY The removal of tissue specimens or fluid from the living Biopsy
body for microscopic examination, performed to establish
a diagnosis.
C85859 EXPECTORATION A technique in which material is cleared from the throat Expectorate
or lungs by coughing it up and spitting it out.
C15361 FINE NEEDLE The removal of tissue specimens or fluid from the living Fine-Needle Aspiration
ASPIRATION body with a thin needle.
C132353 INDUCED A technique in which hypotonic saline is inhaled, followed Induced Expectoration
EXPECTORATION by expectoration. Technique
C38068 LAVAGE A technique in which a cavity or organ is flushed with a Lavage

fluid, which is then collected.
C17627 SWAB A technique in which a tufted material on the end of a Swab

stick is rubbed against a surface.
page 204 of 1925

CLTMDTYP (Culture Medium Type)
C127264 CLTMDTYP
Code Value
C127517 BLOOD AGAR A solid growth medium mainly consisting of peptones, Blood Agar Growth
sodium chloride, meat extracts, and mammalian blood, Medium
which is developed for the cultivation of fastidious
organisms. The blood in the formulation promotes the
presence and visualization of hemolytic reactions,
enabling the detection and differentiation of hemolytic
bacteria.
C150829 CHROMOGENIC A solid growth medium mainly consisting of various Chromogenic Selective
SELECTIVE MEDIUM peptones, taurocholate and a chromogenic substrate Medium
which is developed primarily for the isolation and
cultivation of Clostridium difficile.
C150828 CYCLOSERINE- CCFA A solid growth medium mainly consisting of proteose Cycloserine-Cefoxitin
CEFOXITIN FRUCTOSE peptone, fructose, cycloserine, cefoxitin, fructose, and Fructose Agar
AGAR egg yolk, which is developed primarily for the isolation
and cultivation of Clostridium difficile.
C128949 KIRCHNER MEDIUM A liquid growth medium mainly consisting of sodium Kirchner Growth Medium
dihydrogen phosphate, potassium dihydrogen phosphate,
magnesium sulphate, trisodium citrate, L-asparagine and
phenol red, which is developed for the culture and
recovery of Mycobacteria.
C85507 LOWENSTEIN JENSEN LJ medium A growth medium mainly consisting of malachite green, Lowenstein-Jensen
MEDIUM glycerol, asparagine, coagulated eggs, and mineral salts Medium
which is developed especially for the cultivation of
mycobacterium.
C128950 MB REDOX BROTH A liquid and selective growth medium that is modified MB Redox Broth Growth
based on the Kirchner medium by the addition of a Medium
mixture of antimicrobial agents (typically polymyxin B,
amphotericin B, carbenicillin, and trimethoprim) and
colorless tetrazolium salt as a growth indicator, which is
developed for the cultivation of mycobacterium.
C85509 MIDDLEBROOK 7H10 A solid growth medium mainly consisting of oleic acid- Middlebrook 7H10 Growth
AGAR albumin enrichment, glycerol, dextrose and inorganic Medium
compounds, which is developed especially for the primary
and secondary cultivation of mycobacterium.
C127518 MIDDLEBROOK 7H10S Middlebrook 7H10 A solid and selective growth medium that is modified Middlebrook 7H10S
AGAR Selective Agar based on the Middlebrook 7H10 agar by the addition of Growth Medium
four antimicrobial agents: polymyxin B, carbenicillin,
amphotericin B and trimethoprim lactate.
C85510 MIDDLEBROOK 7H11 A solid growth medium that is modified based on the Middlebrook 7H11 Growth
AGAR Middlebrook 7H10 agar by the addition of pancreatic Medium
digest of casein.
C127519 MIDDLEBROOK 7H11S Middlebrook 7H11 A solid and selective growth medium that is modified Middlebrook 7H11S
AGAR Selective Agar based on the Middlebrook 7H11 agar by the addition of Growth Medium
four antimicrobial agents: polymyxin B, carbenicillin,
amphotericin B and trimethoprim lactate.
C127520 MIDDLEBROOK 7H12 A liquid growth medium that is modified based on the Middlebrook 7H12 Growth
BROTH Middlebrook 7H9 broth by the addition of bovine serum Medium
albumin, casein hydrolysate, catalase and 14C-labelled
palmitic acid.
C127521 MIDDLEBROOK 7H9 A liquid growth medium mainly consisting of albumin, Middlebrook 7H9 Growth
BROTH glycerol, dextrose and inorganic compounds, which is Medium
developed especially for the primary and secondary
cultivation of mycobacterium.
page 205 of 1925

COMM1TC (Current Opioid Misuse Measure Questionnaire Test Code)
C100158 COMM1TC
Code Value
C100958 COMM101 COMM1-Trouble Thinking Current Opioid Misuse Measure - In the past 30 days, COMM - Trouble Thinking
Clearly/Memory how often have you had trouble with thinking clearly or Clearly or Memory
had memory problems? Problems
C100959 COMM102 COMM1-Complaints Not Current Opioid Misuse Measure - In the past 30 days, COMM - Complaints Not
Completing Tasks how often do people complain that you are not Completing Tasks
completing necessary tasks? (i.e., doing things that need
to be done, such as going to class, work or appointments)
C100960 COMM103 COMM1-Other Sources Current Opioid Misuse Measure - In the past 30 days, COMM - Other Sources
For Pain Medication how often have you had to go to someone other than for Pain Medication
your prescribing physician to get sufficient pain relief
from medications? (i.e., another doctor, the Emergency
Room, friends, street source)
C100961 COMM104 COMM1-Taken Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Taken
Other Than Prescribed how often have you taken your medications differently Medications Other Than
from how they are prescribed? Prescribed
C100962 COMM105 COMM1-Seriously Current Opioid Misuse Measure - In the past 30 days, COMM - Seriously
Thought of Hurting Self how often have you seriously thought about hurting Thought of Hurting Self
yourself?
C100963 COMM106 COMM1-Time Spent Current Opioid Misuse Measure - In the past 30 days, COMM - Time Spent
Thinking About Opioids how much of your time was spent thinking about opioid Thinking About Opioids
medications (having enough, taking them, dosing
schedule, etc.)?
C100964 COMM107 COMM1-Been in an Current Opioid Misuse Measure - In the past 30 days, COMM - Been in an
Argument how often have you been in an argument? Argument
C100965 COMM108 COMM1-Trouble Current Opioid Misuse Measure - In the past 30 days, COMM - Trouble
Controlling Anger how often have you had trouble controlling your anger Controlling Anger
(e.g., road rage, screaming, etc.)?
C100966 COMM109 COMM1-Take Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Take Medications
Belonging to Others how often have you needed to take pain medications Belonging to Others
belonging to someone else?
C100967 COMM110 COMM1-Worry About Current Opioid Misuse Measure - In the past 30 days, COMM - Worry About
Handling Meds how often have you been worried about how you're Handling Medications
handling your medications?
C100968 COMM111 COMM1-Others Worry Current Opioid Misuse Measure - In the past 30 days, COMM - Others Worry
About Your Meds how often have others been worried about how you're About Your Medications
C100969 COMM112 COMM1-Emergency Current Opioid Misuse Measure - In the past 30 days, COMM - Emergency
Phone Call/Clinic Visit how often have you had to make an emergency phone Phone Call or Clinic Visit
call or show up at the clinic without an appointment?
C100970 COMM113 COMM1-Gotten Angry Current Opioid Misuse Measure - In the past 30 days, COMM - Gotten Angry
With People how often have you gotten angry with people? With People
C100971 COMM114 COMM1-Take More Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Take More
Than Prescribed how often have you had to take more of your medication Medication Than
than prescribed? Prescribed
C100972 COMM115 COMM1-Borrowed Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Borrowed
From Others how often have you borrowed pain medication from Medication From Others
someone else?
C100973 COMM116 COMM1-Used Pain Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Used Pain
For Other Symptoms how often have you used your pain medicine for Medicine For Other
symptoms other than for pain (e.g., to help you sleep, Symptoms
improve your mood, or relieve stress)?
C100974 COMM117 COMM1-Visit Emergency Current Opioid Misuse Measure - In the past 30 days, COMM - Visit Emergency
Room how often have you had to visit the Emergency Room? Room
C100975 COMM118 COMM1-Score Current Opioid Misuse Measure - Score. COMM - Score
page 206 of 1925

COMM1TN (Current Opioid Misuse Measure Questionnaire Test Name)
C100157 COMM1TN
Code Value
C100964 COMM1-Been in an COMM1-Been in an Current Opioid Misuse Measure - In the past 30 days, COMM - Been in an
Argument Argument how often have you been in an argument? Argument
C100972 COMM1-Borrowed Meds COMM1-Borrowed Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Borrowed
From Others From Others how often have you borrowed pain medication from Medication From Others
someone else?
C100959 COMM1-Complaints Not COMM1-Complaints Not Current Opioid Misuse Measure - In the past 30 days, COMM - Complaints Not
Completing Tasks Completing Tasks how often do people complain that you are not Completing Tasks
completing necessary tasks? (i.e., doing things that need
to be done, such as going to class, work or appointments)
C100969 COMM1-Emergency COMM1-Emergency Current Opioid Misuse Measure - In the past 30 days, COMM - Emergency
Phone Call/Clinic Visit Phone Call/Clinic Visit how often have you had to make an emergency phone Phone Call or Clinic Visit
call or show up at the clinic without an appointment?
C100970 COMM1-Gotten Angry COMM1-Gotten Angry Current Opioid Misuse Measure - In the past 30 days, COMM - Gotten Angry
With People With People how often have you gotten angry with people? With People
C100960 COMM1-Other Sources COMM1-Other Sources Current Opioid Misuse Measure - In the past 30 days, COMM - Other Sources
For Pain Medication For Pain Medication how often have you had to go to someone other than for Pain Medication
your prescribing physician to get sufficient pain relief
from medications? (i.e., another doctor, the Emergency
Room, friends, street source)
C100968 COMM1-Others Worry COMM1-Others Worry Current Opioid Misuse Measure - In the past 30 days, COMM - Others Worry
About Your Meds About Your Meds how often have others been worried about how you're About Your Medications
C100975 COMM1-Score COMM1-Score Current Opioid Misuse Measure - Score. COMM - Score
C100962 COMM1-Seriously COMM1-Seriously Current Opioid Misuse Measure - In the past 30 days, COMM - Seriously
Thought of Hurting Self Thought of Hurting Self how often have you seriously thought about hurting Thought of Hurting Self
yourself?
C100966 COMM1-Take Meds COMM1-Take Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Take Medications
Belonging to Others Belonging to Others how often have you needed to take pain medications Belonging to Others
belonging to someone else?
C100971 COMM1-Take More Meds COMM1-Take More Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Take More
Than Prescribed Than Prescribed how often have you had to take more of your medication Medication Than
than prescribed? Prescribed
C100961 COMM1-Taken Meds COMM1-Taken Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Taken
Other Than Prescribed Other Than Prescribed how often have you taken your medications differently Medications Other Than
from how they are prescribed? Prescribed
C100963 COMM1-Time Spent COMM1-Time Spent Current Opioid Misuse Measure - In the past 30 days, COMM - Time Spent
Thinking About Opioids Thinking About Opioids how much of your time was spent thinking about opioid Thinking About Opioids
medications (having enough, taking them, dosing
schedule, etc.)?
C100965 COMM1-Trouble COMM1-Trouble Current Opioid Misuse Measure - In the past 30 days, COMM - Trouble
Controlling Anger Controlling Anger how often have you had trouble controlling your anger Controlling Anger
(e.g., road rage, screaming, etc.)?
C100958 COMM1-Trouble Thinking COMM1-Trouble Thinking Current Opioid Misuse Measure - In the past 30 days, COMM - Trouble Thinking
Clearly/Memory Clearly/Memory how often have you had trouble with thinking clearly or Clearly or Memory
had memory problems? Problems
C100973 COMM1-Used Pain Meds COMM1-Used Pain Meds Current Opioid Misuse Measure - In the past 30 days, COMM - Used Pain
For Other Symptoms For Other Symptoms how often have you used your pain medicine for Medicine For Other
symptoms other than for pain (e.g., to help you sleep, Symptoms
improve your mood, or relieve stress)?
C100974 COMM1-Visit Emergency COMM1-Visit Emergency Current Opioid Misuse Measure - In the past 30 days, COMM - Visit Emergency
Room Room how often have you had to visit the Emergency Room? Room
C100967 COMM1-Worry About COMM1-Worry About Current Opioid Misuse Measure - In the past 30 days, COMM - Worry About
Handling Meds Handling Meds how often have you been worried about how you're Handling Medications
page 207 of 1925

CONROL (Contact Role for Clinical Study)
C127257 CONROL
Code Value
C127522 CA APPLICANT The person responsible for the competent authority Competent Authority
application. Applicant
C127523 CENTRAL CONTACT FOR The contact person providing centralized, coordinated Central Contact for
RECRUITMENT recruitment information for the entire study. Recruitment
(clinicaltrials.gov)
C127524 CENTRAL CONTACT FOR The secondary contact person providing centralized, Central Contact for
RECRUITMENT BACKUP coordinated recruitment information for the entire study. Recruitment Backup
(clinicaltrials.gov)
C127525 CLINICAL NETWORK The main or principal contact person for the clinical Clinical Investigator
CONTACT investigator network. Network Contact
C127526 CONTACT FOR PUBLIC The study contact person who is responsible for questions Public Queries Study
QUERIES from the public. Contact
C127527 CONTACT FOR The study contact person who is responsible for questions Scientific Queries Study
SCIENTIFIC QUERIES from the scientific community. Contact
C127528 FACILITY CONTACT The main or principal contact person at the facility. Facility Contact
C127529 FACILITY CONTACT The secondary contact person at the facility. Facility Contact Backup
BACKUP
C127530 FURTHER INFORMATION The contact person responsible for disseminating Study Further
CONTACT additional information about the study. Information Contact
C127531 IEC APPLICANT The person responsible for the independent ethics Independent Ethics
committee application. Committee Applicant
C25936 INVESTIGATOR A person responsible for the conduct of the clinical trial at Investigator
a trial site. If a trial is conducted by a team of individuals
at the trial site, the investigator is the responsible leader
of the team and may be called the principle investigator.
C127532 LEGAL REPRESENTATIVE An individual with expertise in the law who provides legal Legal Representative for
FOR THE STUDY counsel and representation for a study. the Study
C127533 PRIMARY CONTACT The main or principal contact person for the study. Primary Study Contact
C19924 PRINCIPAL A person who has the primary responsibility for the Principal Investigator
INVESTIGATOR conduct of a clinical study and study-related personnel at
a study site. While a single-center study would not
include a coordinating investigator, the investigator at the
site would fulfill the same responsibilities as a principal
investigator.
C51878 STUDY CHAIR Study Director A person who has overall responsibility for the technical Study Chair
conduct of a study, as well as for the interpretation,
analysis, documentation and reporting of results, and
represents the single point of study control. (FDA)
C127534 SUBCONTRACTOR The main or principal contact person for the Subcontractor Contact
CONTACT subcontractor or subcontracting organization.
C54622 SUBINVESTIGATOR Any member of the clinical trial team designated and Subinvestigator
supervised by the investigator at a trial site to perform
critical trial-related procedures and/or to make important
trial-related decisions (e.g., associates, residents,
research fellows). (ICH)
page 208 of 1925

COWAT1TC (Controlled Oral Word Association Test Functional Test Test Code)
C150766 COWAT1TC
Code Value
C150922 COWAT101 COWAT1-Another Word Controlled Oral Word Association Test - Can you tell me COWAT - Another Word
That Begins With R another word that begins with R? That Begins With R
C150923 COWAT102 COWAT1-Number Correct Controlled Oral Word Association Test - Number correct COWAT - Number Correct
Words: C words: Now I'm going to give you another letter, and Words: C
again, say all words beginning with that letter that you
can think of. You will have a minute for each one. The
first letter is C.
Words: F words: Now I am going to give another letter. Tell me as Words: F
many words as you can that begin with F. Tell me as
many words as quickly as you can that begin with F.
Words: L words: Now I am going to give another letter. Tell me as Words: L
many words as you can that begin with L. Tell me as
many words as quickly as you can that begin with L.
page 209 of 1925

COWAT1TN (Controlled Oral Word Association Test Functional Test Test Name)
C150765 COWAT1TN
Code Value
C150922 COWAT1-Another Word COWAT1-Another Word Controlled Oral Word Association Test - Can you tell me COWAT - Another Word
That Begins With R That Begins With R another word that begins with R? That Begins With R
C150923 COWAT1-Number Correct COWAT1-Number Correct Controlled Oral Word Association Test - Number correct COWAT - Number Correct
Words: C Words: C words: Now I'm going to give you another letter, and Words: C
again, say all words beginning with that letter that you
can think of. You will have a minute for each one. The
first letter is C.
Words: F Words: F words: Now I am going to give another letter. Tell me as Words: F
many words as you can that begin with F. Tell me as
many words as quickly as you can that begin with F.
Words: L Words: L words: Now I am going to give another letter. Tell me as Words: L
many words as you can that begin with L. Tell me as
many words as quickly as you can that begin with L.
page 210 of 1925

COWS1TC (Clinical Opiate Withdrawal Scale Questionnaire Test Code)
C101813 COWS1TC
Code Value
C102056 COWS101 COWS1-Resting Pulse Clinical Opiate Withdrawal Scale - Resting pulse rate. COWS - Resting Pulse
Rate Rate
C112467 COWS101A COWS1-Resting Pulse Clinical Opiate Withdrawal Scale - Resting pulse rate: COWS - Resting Pulse
Rate Beats/Minute beats/minute. Rate: Beats/Minute
C102057 COWS102 COWS1-Sweating Clinical Opiate Withdrawal Scale - Sweating. COWS - Sweating
C102058 COWS103 COWS1-Restlessness Clinical Opiate Withdrawal Scale - Restlessness. COWS - Restlessness
C102059 COWS104 COWS1-Pupil Size Clinical Opiate Withdrawal Scale - Pupil size. COWS - Pupil Size
C102060 COWS105 COWS1-Bone or Joint Clinical Opiate Withdrawal Scale - Bone or joint aches. COWS - Bone or Joint
Aches Aches
C102061 COWS106 COWS1-Runny Nose or Clinical Opiate Withdrawal Scale - Runny nose or tearing. COWS - Runny Nose or
Tearing Tearing
C102062 COWS107 COWS1-GI Upset Clinical Opiate Withdrawal Scale - GI upset. COWS - GI Upset
C102063 COWS108 COWS1-Tremor Clinical Opiate Withdrawal Scale - Tremor. COWS - Tremor
C102064 COWS109 COWS1-Yawning Clinical Opiate Withdrawal Scale - Yawning. COWS - Yawning
C102065 COWS110 COWS1-Anxiety or Clinical Opiate Withdrawal Scale - Anxiety or irritability. COWS - Anxiety or
Irritability Irritability
C102066 COWS111 COWS1-Gooseflesh Skin Clinical Opiate Withdrawal Scale - Gooseflesh skin. COWS - Gooseflesh Skin
C112468 COWS112 COWS1-Total Score Clinical Opiate Withdrawal Scale - Total score. COWS - Total Score
page 211 of 1925

COWS1TN (Clinical Opiate Withdrawal Scale Questionnaire Test Name)
C101814 COWS1TN
Code Value
C102065 COWS1-Anxiety or COWS1-Anxiety or Clinical Opiate Withdrawal Scale - Anxiety or irritability. COWS - Anxiety or
Irritability Irritability Irritability
C102060 COWS1-Bone or Joint COWS1-Bone or Joint Clinical Opiate Withdrawal Scale - Bone or joint aches. COWS - Bone or Joint
Aches Aches Aches
C102062 COWS1-GI Upset COWS1-GI Upset Clinical Opiate Withdrawal Scale - GI upset. COWS - GI Upset
C102066 COWS1-Gooseflesh Skin COWS1-Gooseflesh Skin Clinical Opiate Withdrawal Scale - Gooseflesh skin. COWS - Gooseflesh Skin
C102059 COWS1-Pupil Size COWS1-Pupil Size Clinical Opiate Withdrawal Scale - Pupil size. COWS - Pupil Size
C102056 COWS1-Resting Pulse COWS1-Resting Pulse Clinical Opiate Withdrawal Scale - Resting pulse rate. COWS - Resting Pulse
Rate Rate Rate
C112467 COWS1-Resting Pulse COWS1-Resting Pulse Clinical Opiate Withdrawal Scale - Resting pulse rate: COWS - Resting Pulse
Rate Beats/Minute Rate Beats/Minute beats/minute. Rate: Beats/Minute
C102058 COWS1-Restlessness COWS1-Restlessness Clinical Opiate Withdrawal Scale - Restlessness. COWS - Restlessness
C102061 COWS1-Runny Nose or COWS1-Runny Nose or Clinical Opiate Withdrawal Scale - Runny nose or tearing. COWS - Runny Nose or
Tearing Tearing Tearing
C102057 COWS1-Sweating COWS1-Sweating Clinical Opiate Withdrawal Scale - Sweating. COWS - Sweating
C112468 COWS1-Total Score COWS1-Total Score Clinical Opiate Withdrawal Scale - Total score. COWS - Total Score
C102063 COWS1-Tremor COWS1-Tremor Clinical Opiate Withdrawal Scale - Tremor. COWS - Tremor
C102064 COWS1-Yawning COWS1-Yawning Clinical Opiate Withdrawal Scale - Yawning. COWS - Yawning
page 212 of 1925

CPFATS (COPD Findings About Test Name)
C122006 CPFATS
Code Value
C94596 Cumulative Exposure Cumulative Exposure The total amount that a subject is exposed to over time. Cumulative Exposure
C124328 Number of Mild Episodes Number of Mild Episodes The number of times an event, which is classified as mild, Number of Mild Episodes
occurred.
C124329 Number of Moderate Number of Moderate The number of times an event, which is classified as Number of Moderate
Episodes Episodes moderate, occurred. Episodes
C124330 Number of Severe Number of Severe The number of times an event, which is classified as Number of Severe
Episodes Episodes severe, occurred. Episodes
page 213 of 1925

CPFATSCD (COPD Findings About Test Code)
C122007 CPFATSCD
Code Value
C94596 CUMEXP Cumulative Exposure The total amount that a subject is exposed to over time. Cumulative Exposure
C124328 EPMLDNUM Number of Mild Episodes The number of times an event, which is classified as mild, Number of Mild Episodes
occurred.
C124329 EPMODNUM Number of Moderate The number of times an event, which is classified as Number of Moderate
Episodes moderate, occurred. Episodes
C124330 EPSEVNUM Number of Severe The number of times an event, which is classified as Number of Severe
Episodes severe, occurred. Episodes
page 214 of 1925

CPS01TC (Child-Pugh Classification Clinical Classification Test Code)
C120989 CPS01TC
Code Value
C121068 CPS0101 CPS01-Encephalopathy Child-Pugh Classification - Encephalopathy grade. Child-Pugh -

Grade Encephalopathy Grade
C121069 CPS0102 CPS01-Ascites Child-Pugh Classification - Ascites. Child-Pugh - Ascites
C121070 CPS0103 CPS01-Serum Bilirubin Child-Pugh Classification - Serum bilirubin, mg/dL. Child-Pugh - Serum
Bilirubin
C121071 CPS0104 CPS01-Serum Albumin Child-Pugh Classification - Serum albumin, g/dL. Child-Pugh - Serum
Albumin
C121072 CPS0105A CPS01-PT, Sec Prolonged Child-Pugh Classification - Prothrombin time, sec Child-Pugh - PT, Sec
prolonged. Prolonged
C121073 CPS0105B CPS01-PT, INR Child-Pugh Classification - Prothrombin time, international Child-Pugh - PT, INR
normalized ratio (INR).
C121074 CPS0106 CPS01-Total Score Child-Pugh Classification - Child-Pugh total score. Child-Pugh - Total Score
C121075 CPS0107 CPS01-Grade Child-Pugh Classification - Child-Pugh grade. Child-Pugh - Grade
page 215 of 1925

CPS01TN (Child-Pugh Classification Clinical Classification Test Name)
C120988 CPS01TN
Code Value
C121069 CPS01-Ascites CPS01-Ascites Child-Pugh Classification - Ascites. Child-Pugh - Ascites
C121068 CPS01-Encephalopathy CPS01-Encephalopathy Child-Pugh Classification - Encephalopathy grade. Child-Pugh -

Grade Grade Encephalopathy Grade
C121075 CPS01-Grade CPS01-Grade Child-Pugh Classification - Child-Pugh grade. Child-Pugh - Grade
C121073 CPS01-PT, INR CPS01-PT, INR Child-Pugh Classification - Prothrombin time, international Child-Pugh - PT, INR
normalized ratio (INR).
C121072 CPS01-PT, Sec Prolonged CPS01-PT, Sec Prolonged Child-Pugh Classification - Prothrombin time, sec Child-Pugh - PT, Sec
prolonged. Prolonged
C121071 CPS01-Serum Albumin CPS01-Serum Albumin Child-Pugh Classification - Serum albumin, g/dL. Child-Pugh - Serum
Albumin
C121070 CPS01-Serum Bilirubin CPS01-Serum Bilirubin Child-Pugh Classification - Serum bilirubin, mg/dL. Child-Pugh - Serum
Bilirubin
C121074 CPS01-Total Score CPS01-Total Score Child-Pugh Classification - Child-Pugh total score. Child-Pugh - Total Score
page 216 of 1925

CRQ01TC (Chronic Respiratory Questionnaire Self-Administered Standardized Format First
Administration Version Questionnaire Test Code)
C120979 CRQ01TC
Code Value
C121010 CRQ0101 CRQ01-Feeling Emotional Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - Feeling emotional such as angry or upset. Feeling Emotional
C121011 CRQ0102 CRQ01-Take Care of Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Basic Needs Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - Taking care of your basic needs. Take Care of Basic Needs
C121012 CRQ0103 CRQ01-Walking Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Version - Walking. Walking
C121013 CRQ0104 CRQ01-Performing Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Chores Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - Performing chores. Performing Chores
C121014 CRQ0105 CRQ01-Participate in Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Social Activities Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - Participating in social activities. Participate in Social
Activities
C121015 CRQ0106 CRQ01-Felt Frustrated or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Impatient Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - In general, how much of the time during the Felt Frustrated or
last 2 weeks have you felt frustrated or impatient? Impatient
C121016 CRQ0107 CRQ01-Feeling of Fear or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Panic Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - How often during the last 2 weeks did you have Feeling of Fear or Panic
a feeling of fear or panic when you had difficulty getting
your breath?
C121017 CRQ0108 CRQ01-Fatigue Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Version - How about fatigue? How tired have you felt over Fatigue
the last 2 weeks?
C121018 CRQ0109 CRQ01-Embarrassed by Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Coughing Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - How often during the last 2 weeks have you felt Embarrassed by Coughing
embarrassed by your coughing or heavy breathing?
C121019 CRQ0110 CRQ01-Confident to Deal Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
With Illness Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - In the last 2 weeks, how much of the time did Feel Confident to Deal
you feel very confident and sure that you could deal with With Illness
your illness?
C121020 CRQ0111 CRQ01-Energy Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Version - How much energy have you had in the last 2 Energy
weeks?
C121021 CRQ0112 CRQ01-Feel Upset, Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Worried or Depressed Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - In general, how much of the time did you feel Feel Upset, Worried or
upset, worried, or depressed during the last 2 weeks? Depressed
C121022 CRQ0113 CRQ01-Control of Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Breathing Problems Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - How often during the last 2 weeks did you feel Had Control of Breathing
you had complete control of your breathing problems? Problems
C121023 CRQ0114 CRQ01-Feel Relaxed and Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Free of Tension Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - How much of the time during the last 2 weeks Feel Relaxed and Free of
did you feel relaxed and free of tension? Tension
C121024 CRQ0115 CRQ01-Felt Low in Energy Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Version - How often during the last 2 weeks have you felt Felt Low in Energy
low in energy?
C121025 CRQ0116 CRQ01-Felt Discouraged Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
or Down Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - In general, how often during the last 2 weeks Felt Discouraged or Down
have you felt discouraged or down in the dumps?
page 217 of 1925

C120979 CRQ01TC
Code Value
C121026 CRQ0117 CRQ01-Felt Worn Out or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Sluggish Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - How often during the last 2 weeks have you felt Felt Worn Out or Sluggish
worn out or sluggish?
C121027 CRQ0118 CRQ01-Happy, Satisfied Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
or Pleased Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - How happy, satisfied, or pleased have you been Happy, Satisfied or
with your personal life during the last 2 weeks? Pleased With Life
C121028 CRQ0119 CRQ01-Feel Upset Diff Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Getting Breath Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - How often during the last 2 weeks did you feel Feel Upset When Had
upset or scared when you had difficulty getting your Difficulty Getting Breath
breath?
C121029 CRQ0120 CRQ01-Felt Restless, Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Tense or Uptight Standardized Format (CRQ-SAS) First Administration Administration Version -
Version - In general, how often during the last 2 weeks Felt Restless, Tense or
have you felt restless, tense, or uptight? Uptight
page 218 of 1925

CRQ01TN (Chronic Respiratory Questionnaire Self-Administered Standardized Format First
Administration Version Questionnaire Test Name)
C120978 CRQ01TN
Code Value
C121019 CRQ01-Confident to Deal CRQ01-Confident to Deal Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
With Illness With Illness Standardized Format (CRQ-SAS) First Administration Administration Version -
your illness?
C121022 CRQ01-Control of CRQ01-Control of Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Breathing Problems Breathing Problems Standardized Format (CRQ-SAS) First Administration Administration Version -
C121018 CRQ01-Embarrassed by CRQ01-Embarrassed by Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Coughing Coughing Standardized Format (CRQ-SAS) First Administration Administration Version -
C121020 CRQ01-Energy CRQ01-Energy Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

weeks?
C121017 CRQ01-Fatigue CRQ01-Fatigue Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

the last 2 weeks?
C121023 CRQ01-Feel Relaxed and CRQ01-Feel Relaxed and Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Free of Tension Free of Tension Standardized Format (CRQ-SAS) First Administration Administration Version -
C121028 CRQ01-Feel Upset Diff CRQ01-Feel Upset Diff Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Getting Breath Getting Breath Standardized Format (CRQ-SAS) First Administration Administration Version -
breath?
C121021 CRQ01-Feel Upset, CRQ01-Feel Upset, Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Worried or Depressed Worried or Depressed Standardized Format (CRQ-SAS) First Administration Administration Version -
C121010 CRQ01-Feeling Emotional CRQ01-Feeling Emotional Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
C121016 CRQ01-Feeling of Fear or CRQ01-Feeling of Fear or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Panic Panic Standardized Format (CRQ-SAS) First Administration Administration Version -
your breath?
C121025 CRQ01-Felt Discouraged CRQ01-Felt Discouraged Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
or Down or Down Standardized Format (CRQ-SAS) First Administration Administration Version -
C121015 CRQ01-Felt Frustrated or CRQ01-Felt Frustrated or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Impatient Impatient Standardized Format (CRQ-SAS) First Administration Administration Version -
C121024 CRQ01-Felt Low in Energy CRQ01-Felt Low in Energy Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
low in energy?
C121029 CRQ01-Felt Restless, CRQ01-Felt Restless, Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Tense or Uptight Tense or Uptight Standardized Format (CRQ-SAS) First Administration Administration Version -
C121026 CRQ01-Felt Worn Out or CRQ01-Felt Worn Out or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Sluggish Sluggish Standardized Format (CRQ-SAS) First Administration Administration Version -
page 219 of 1925

C120978 CRQ01TN
Code Value
C121027 CRQ01-Happy, Satisfied CRQ01-Happy, Satisfied Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
or Pleased or Pleased Standardized Format (CRQ-SAS) First Administration Administration Version -
C121014 CRQ01-Participate in CRQ01-Participate in Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Social Activities Social Activities Standardized Format (CRQ-SAS) First Administration Administration Version -
Activities
C121013 CRQ01-Performing CRQ01-Performing Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

Chores Chores Standardized Format (CRQ-SAS) First Administration Administration Version -
C121011 CRQ01-Take Care of CRQ01-Take Care of Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First
Basic Needs Basic Needs Standardized Format (CRQ-SAS) First Administration Administration Version -
C121012 CRQ01-Walking CRQ01-Walking Chronic Respiratory Questionnaire Self-Administered CRQ-SAS First

page 220 of 1925

CRQ02TC (Chronic Respiratory Questionnaire Self-Administered Standardized Format Follow-Up
Administration Version Questionnaire Test Code)
C120981 CRQ02TC
Code Value
C121030 CRQ0201 CRQ02-Feeling Emotional Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121031 CRQ0202 CRQ02-Take Care of Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Basic Needs Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121032 CRQ0203 CRQ02-Walking Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

C121033 CRQ0204 CRQ02-Performing Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

Chores Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121034 CRQ0205 CRQ02-Participate in Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

Social Activities Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
Activities
C121035 CRQ0206 CRQ02-Felt Frustrated or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Impatient Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121036 CRQ0207 CRQ02-Feeling of Fear or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Panic Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
your breath?
C121037 CRQ0208 CRQ02-Fatigue Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

the last 2 weeks?
C121038 CRQ0209 CRQ02-Embarrassed by Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

Coughing Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121039 CRQ0210 CRQ02-Confident to Deal Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
With Illness Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
your illness?
C121040 CRQ0211 CRQ02-Energy Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

weeks?
C121041 CRQ0212 CRQ02-Feel Upset, Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Worried or Depressed Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121042 CRQ0213 CRQ02-Control of Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

Breathing Problems Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121043 CRQ0214 CRQ02-Feel Relaxed and Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Free of Tension Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121044 CRQ0215 CRQ02-Felt Low in Energy Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
low in energy?
C121045 CRQ0216 CRQ02-Felt Discouraged Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
or Down Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
page 221 of 1925

C120981 CRQ02TC
Code Value
C121046 CRQ0217 CRQ02-Felt Worn Out or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Sluggish Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121047 CRQ0218 CRQ02-Happy, Satisfied Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
or Pleased Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121048 CRQ0219 CRQ02-Feel Upset Diff Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Getting Breath Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
breath?
C121049 CRQ0220 CRQ02-Felt Restless, Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Tense or Uptight Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
page 222 of 1925

CRQ02TN (Chronic Respiratory Questionnaire Self-Administered Standardized Format Follow-Up
Administration Version Questionnaire Test Name)
C120980 CRQ02TN
Code Value
C121039 CRQ02-Confident to Deal CRQ02-Confident to Deal Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
With Illness With Illness Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
your illness?
C121042 CRQ02-Control of CRQ02-Control of Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

Breathing Problems Breathing Problems Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121038 CRQ02-Embarrassed by CRQ02-Embarrassed by Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

Coughing Coughing Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121040 CRQ02-Energy CRQ02-Energy Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

weeks?
C121037 CRQ02-Fatigue CRQ02-Fatigue Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

the last 2 weeks?
C121043 CRQ02-Feel Relaxed and CRQ02-Feel Relaxed and Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Free of Tension Free of Tension Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121048 CRQ02-Feel Upset Diff CRQ02-Feel Upset Diff Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Getting Breath Getting Breath Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
breath?
C121041 CRQ02-Feel Upset, CRQ02-Feel Upset, Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Worried or Depressed Worried or Depressed Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121030 CRQ02-Feeling Emotional CRQ02-Feeling Emotional Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
C121036 CRQ02-Feeling of Fear or CRQ02-Feeling of Fear or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Panic Panic Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
your breath?
C121045 CRQ02-Felt Discouraged CRQ02-Felt Discouraged Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
or Down or Down Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121035 CRQ02-Felt Frustrated or CRQ02-Felt Frustrated or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Impatient Impatient Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121044 CRQ02-Felt Low in Energy CRQ02-Felt Low in Energy Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
low in energy?
C121049 CRQ02-Felt Restless, CRQ02-Felt Restless, Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Tense or Uptight Tense or Uptight Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121046 CRQ02-Felt Worn Out or CRQ02-Felt Worn Out or Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Sluggish Sluggish Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
page 223 of 1925

C120980 CRQ02TN
Code Value
C121047 CRQ02-Happy, Satisfied CRQ02-Happy, Satisfied Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
or Pleased or Pleased Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121034 CRQ02-Participate in CRQ02-Participate in Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

Social Activities Social Activities Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
Activities
C121033 CRQ02-Performing CRQ02-Performing Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

Chores Chores Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121031 CRQ02-Take Care of CRQ02-Take Care of Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up
Basic Needs Basic Needs Standardized Format (CRQ-SAS) Follow-up Administration Administration Version -
C121032 CRQ02-Walking CRQ02-Walking Chronic Respiratory Questionnaire Self-Administered CRQ-SAS Follow-Up

page 224 of 1925

CRSR01TC (JFK Coma Recovery Scale-Revised Clinical Classification Test Code)
C124684 CRSR01TC
Code Value
C124736 CRSR0101 CRSR01-Diagnosis JFK Coma Recovery Scale-Revised - Diagnosis. CRS-R - Diagnosis
C124737 CRSR0102 CRSR01-Etiology JFK Coma Recovery Scale-Revised - Etiology. CRS-R - Etiology
C124738 CRSR0103 CRSR01-Date of Onset JFK Coma Recovery Scale-Revised - Date of onset. CRS-R - Date of Onset
C124739 CRSR0104 CRSR01-Date of JFK Coma Recovery Scale-Revised - Date of admission. CRS-R - Date of
Admission Admission
C124740 CRSR0105 CRSR01-Auditory JFK Coma Recovery Scale-Revised - Auditory function CRS-R - Auditory
Function Scale scale. Function Scale
C124741 CRSR0106 CRSR01-Visual Function JFK Coma Recovery Scale-Revised - Visual function scale. CRS-R - Visual Function
Scale Scale
C124742 CRSR0107 CRSR01-Motor Function JFK Coma Recovery Scale-Revised - Motor function scale. CRS-R - Motor Function
Scale Scale
C124743 CRSR0108 CRSR01-Oromotor/Verbal JFK Coma Recovery Scale-Revised - Oromotor/verbal CRS-R - Oromotor/Verbal
Function function scale. Function
C124744 CRSR0109 CRSR01-Communication JFK Coma Recovery Scale-Revised - Communication CRS-R - Communication
Scale scale. Scale
C124745 CRSR0110 CRSR01-Arousal Scale JFK Coma Recovery Scale-Revised - Arousal scale. CRS-R - Arousal Scale
C124746 CRSR0111 CRSR01-Total Score JFK Coma Recovery Scale-Revised - Total score. CRS-R - Total Score
page 225 of 1925

CRSR01TN (JFK Coma Recovery Scale-Revised Clinical Classification Test Name)
C124683 CRSR01TN
Code Value
C124745 CRSR01-Arousal Scale CRSR01-Arousal Scale JFK Coma Recovery Scale-Revised - Arousal scale. CRS-R - Arousal Scale
C124740 CRSR01-Auditory CRSR01-Auditory JFK Coma Recovery Scale-Revised - Auditory function CRS-R - Auditory
Function Scale Function Scale scale. Function Scale
C124744 CRSR01-Communication CRSR01-Communication JFK Coma Recovery Scale-Revised - Communication CRS-R - Communication
Scale Scale scale. Scale
C124739 CRSR01-Date of CRSR01-Date of JFK Coma Recovery Scale-Revised - Date of admission. CRS-R - Date of
Admission Admission Admission
C124738 CRSR01-Date of Onset CRSR01-Date of Onset JFK Coma Recovery Scale-Revised - Date of onset. CRS-R - Date of Onset
C124736 CRSR01-Diagnosis CRSR01-Diagnosis JFK Coma Recovery Scale-Revised - Diagnosis. CRS-R - Diagnosis
C124737 CRSR01-Etiology CRSR01-Etiology JFK Coma Recovery Scale-Revised - Etiology. CRS-R - Etiology
C124742 CRSR01-Motor Function CRSR01-Motor Function JFK Coma Recovery Scale-Revised - Motor function scale. CRS-R - Motor Function
Scale Scale Scale
C124743 CRSR01-Oromotor/Verbal CRSR01-Oromotor/Verbal JFK Coma Recovery Scale-Revised - Oromotor/verbal CRS-R - Oromotor/Verbal
Function Function function scale. Function
C124746 CRSR01-Total Score CRSR01-Total Score JFK Coma Recovery Scale-Revised - Total score. CRS-R - Total Score
C124741 CRSR01-Visual Function CRSR01-Visual Function JFK Coma Recovery Scale-Revised - Visual function scale. CRS-R - Visual Function
Scale Scale Scale
page 226 of 1925

CRYDFMAN (Cardiac Rhythm Device Failure Manifestation)
C101866 CRYDFMAN
Code Value
C99921 ATRIAL PACING The cardiac rhythm device malfunction affected atrial Cardiac Atrial Pacing
MALFUNCTION pacing. Malfunction
C99923 DEFIBRILLATION The cardiac rhythm device malfunction affected the Cardiac Defibrillator
MALFUNCTION defibrillator. Malfunction
C99973 LEFT VENTRICULAR The cardiac rhythm device malfunction affected the left Left Cardiac Ventricular
PACING MALFUNCTION ventricular (LV) pacing. Pacing Malfunction
C100011 RIGHT VENTRICULAR The cardiac rhythm device malfunction affected the right Right Cardiac Ventricle
PACING MALFUNCTION ventricular (RV) pacing. Pacing Malfunction
page 227 of 1925

CSLVLNIM (Reason CS/LV Lead Not Implanted)
C101864 CSLVLNIM
Code Value
C100025 COULD NOT OBTAIN The coronary sinus/left ventricular lead was not Unable to Obtain
ACCEPTABLE PACING implanted because the operator was unable to obtain Acceptable Pacing
THRESHOLDS acceptable pacing thresholds. Thresholds
C99933 LEAD POSITION RESULTS The coronary sinus/left ventricular lead was not Cardiac Lead Position
IN UNDESIRABLE implanted because the lead position resulted in Results in Undesirable
STIMULATION OF THE undesirable stimulation of the diaphragm. Stimulation of Diaphragm
DIAPHRAGM
C100007 PREVIOUSLY IMPLANTED The coronary sinus/left ventricular lead was not Previously Implanted
implanted because a lead had been previously implanted. Cardiac Lead
C100026 UNABLE TO OBTAIN The coronary sinus/left ventricular lead was not Unable to Obtain
SATISFACTORY implanted because the operator was unable to obtain Satisfactory Coronary
CORONARY SINUS satisfactory coronary sinus access. Sinus Access
ACCESS
C100027 UNABLE TO OBTAIN The coronary sinus/left ventricular lead was not Unable to Obtain
SATISFACTORY implanted because the operator was unable to obtain Satisfactory Vascular
VASCULAR ACCESS satisfactory vascular access. Access
C100028 UNABLE TO POSITION The coronary sinus/left ventricular lead was not Unable to Position Lead
LEAD DUE TO CORONARY implanted because the coronary sinus was dissected. Due to Coronary Sinus
SINUS DISSECTION Dissection
C100029 UNABLE TO POSITION The coronary sinus/left ventricular lead was not Unable to Position Lead
LEAD IN TRIBUTARY VEIN implanted because the operator was unable to position In tributary Vein of
OF CORONARY SINUS the lead in the tributary vein of the coronary sinus. Coronary Sinus
page 228 of 1925

CSS01TC (Columbia-Suicide Severity Rating Scale Baseline Questionnaire Test Code)
C100168 CSS01TC
Code Value
C100976 CSS0101 CSS01-Wish to be Dead Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline - Wish
you wished you were dead or wished you could go to to be Dead or go to Sleep
sleep and not wake up? and not Wake Up
C100977 CSS0101A CSS01-Wish to be Dead, Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Describe Description of wishing to be dead. Description of Wish to be
Dead
C100978 CSS0102 CSS01-Non-Specific Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline - Non-
Suicidal Thought you actually had any thoughts of killing yourself? Specific Suicidal Thought
C100979 CSS0102A CSS01-Non-Specific Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Suicid Thought, Descr Description of non-specific active suicidal thoughts. Description of Non-
Specific Suicide Thought
C100980 CSS0103 CSS01-Suicidal Ideation- Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline -
No Intent you been thinking about how you might do this? Suicidal Ideation-No
Intent
C100981 CSS0103A CSS01-Suicidal Ideation- Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
No Intent, Descr Description of active suicidal ideation with any methods Description of Suicidal
(not plan) without intent to act. Ideation-No Intent
C101014 CSS0104 CSS01-Ideation With Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline -
Intent, No Plan you have these thoughts and had some intention of Ideation With Intent, No
acting on them? Plan
C101015 CSS0104A CSS01-Ideation With Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Intent No Plan Descr Description of active suicidal ideation with some intent to Description of Ideation
act, without specific plan. With Intent, No Plan
C100982 CSS0105 CSS01-Ideation With Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline -
Plan/Intent you started to work out or worked out the details of how Ideation With Plan/Intent
to kill yourself? Do you intend to carry out this plan?
C100983 CSS0105A CSS01-Ideation With Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Plan/Intent, Descr Description of active suicidal ideation with specific plan Description of Ideation
and intent. With Plan and Intent
C100984 CSS0106 CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Ideation severe ideation. Severe Ideation
C100985 CSS0106A CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Ideation, Description Description of most severe ideation. Describe Most Severe
Ideation
C100986 CSS0107 CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - How C-SSRS Baseline -
Ideation, Frequency many times have you had these thoughts? Frequency of Most Severe
Ideation
C100987 CSS0108 CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - When C-SSRS Baseline -
Ideation, Duration you have the thoughts, how long do they last? Duration of Most Severe
Ideation
C100988 CSS0109 CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Ideation, Control Could/can you stop thinking about killing yourself or Control over Most Severe
wanting to die if you want to? Ideation
C100989 CSS0110 CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - Are C-SSRS Baseline -
Ideation, Deterrents there things - anyone or anything (e.g., family, religion, Deterrents to Most
pain of death) - that stopped you from wanting to die or Severe Ideation
acting on thoughts of committing suicide?
C100990 CSS0111 CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - What C-SSRS Baseline -
Ideation, Reasons sort of reasons did you have for thinking about wanting to Reasons for Most Severe
die or killing yourself? Was it to end the pain or stop the Ideation
way you were feeling (in other words you couldn't go on
living with this pain or how you were feeling) or was it to
get attention, revenge or a reaction from others? Or
both?
C100991 CSS0112 CSS01-Actual Attempt Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline - Actual
you made a suicide attempt? Have you done anything to Suicide Attempt
harm yourself? Have you done anything dangerous where
you could have died?
C100992 CSS0113 CSS01-Number of Actual Columbia-Suicide Severity Rating Scale Baseline - Total C-SSRS Baseline -
Attempts number of actual attempts. Number of Actual Suicide
Attempts
page 229 of 1925

C100168 CSS01TC
Code Value
C100993 CSS0113A CSS01-Actual Attempt, Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Describe Description of actual attempt. Description of Actual
Suicide Attempts
C100994 CSS0114 CSS01-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Baseline - Has the C-SSRS Baseline - Non-
injurious Behav subject engaged in non-suicidal self-injurious behavior. suicidal Self-injurious
Behavior
C100995 CSS0115 CSS01-Interrupted Columbia-Suicide Severity Rating Scale Baseline - Has C-SSRS Baseline -
Attempt there been a time when you started to do something to Interrupted Suicide
try to end your life but someone or something stopped Attempt
you before you actually did anything?
C100996 CSS0116 CSS01-Number of Columbia-Suicide Severity Rating Scale Baseline - Total C-SSRS Baseline -
Interrupted Attempts number of interrupted attempts. Number of Interrupted
Suicide Attempts
C100997 CSS0116A CSS01-Interrupted Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Attempt, Describe Description of interrupted attempt. Description of Interrupted
Suicide Attempt
C100998 CSS0117 CSS01-Aborted Attempt Columbia-Suicide Severity Rating Scale Baseline - Has C-SSRS Baseline -
there been a time when you started to do something to Aborted Suicide Attempt
try to end your life but you stopped yourself before you
actually did anything?
C100999 CSS0118 CSS01-Number of Columbia-Suicide Severity Rating Scale Baseline - Total C-SSRS Baseline -
Aborted Attempts number of aborted attempts. Number of Aborted
Suicide Attempts
C101000 CSS0118A CSS01-Aborted Attempt, Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Describe Description of aborted attempt. Description of Aborted
Suicide Attempt
C101001 CSS0119 CSS01-Preparatory Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline -
Acts/Behavior you taken any steps towards making a suicide attempt or Preparatory Acts or
preparing to kill yourself (such as collecting pills, getting Behaviors Toward Suicide
a gun, giving valuables away or writing a suicide note)? Attempt
C101002 CSS0119A CSS01-Preparatory Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Acts/Behavior, Descr Description of preparatory acts or behavior. Description of Preparatory
Acts or Behaviors Toward
Suicide Attempt
C101003 CSS0120 CSS01-Suicidal Behavior Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Suicidal behavior was present during the assessment Suicidal Behavior
period?
C101004 CSS0121A CSS01-Most Recent Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Attempt Date recent attempt date. Recent Suicide Attempt
Date
C101005 CSS0121B CSS01-Most Recent Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Attempt Damage recent attempt actual lethality/medical damage. Recent Suicide Attempt
Damage
C101006 CSS0121C CSS01-Most Recent Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Attempt Potential recent attempt potential lethality. Recent Suicide Attempt
Potential
C101007 CSS0122A CSS01-Most Lethal Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Attempt Date lethal attempt date. Lethal Suicide Attempt
Date
C101008 CSS0122B CSS01-Most Lethal Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Attempt Damage lethal attempt actual lethality/medical damage. Lethal Suicide Attempt
Damage
C101009 CSS0122C CSS01-Most Lethal Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Attempt Potential lethal attempt potential lethality. Lethal Suicide Attempt
Potential
C101010 CSS0123A CSS01-First Attempt Date Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline - First
Initial/first attempt date. Suicide Attempt Date
C101011 CSS0123B CSS01-First Attempt Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline - First
Damage Initial/first attempt actual lethality/medical damage. Suicide Attempt Damage
C101012 CSS0123C CSS01-First Attempt Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline - First
Potential Initial/first attempt potential lethality. Suicide Attempt Potential
page 230 of 1925

CSS01TN (Columbia-Suicide Severity Rating Scale Baseline Questionnaire Test Name)
C100167 CSS01TN
Code Value
C100998 CSS01-Aborted Attempt CSS01-Aborted Attempt Columbia-Suicide Severity Rating Scale Baseline - Has C-SSRS Baseline -
C101000 CSS01-Aborted Attempt, CSS01-Aborted Attempt, Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Describe Describe Description of aborted attempt. Description of Aborted
Suicide Attempt
C100991 CSS01-Actual Attempt CSS01-Actual Attempt Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline - Actual
you made a suicide attempt? Have you done anything to Suicide Attempt
C100993 CSS01-Actual Attempt, CSS01-Actual Attempt, Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Describe Describe Description of actual attempt. Description of Actual
Suicide Attempts
C101011 CSS01-First Attempt CSS01-First Attempt Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline - First
Damage Damage Initial/first attempt actual lethality/medical damage. Suicide Attempt Damage
C101010 CSS01-First Attempt Date CSS01-First Attempt Date Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline - First
C101012 CSS01-First Attempt CSS01-First Attempt Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline - First
Potential Potential Initial/first attempt potential lethality. Suicide Attempt Potential
C101015 CSS01-Ideation With CSS01-Ideation With Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Intent No Plan Descr Intent No Plan Descr Description of active suicidal ideation with some intent to Description of Ideation
C101014 CSS01-Ideation With CSS01-Ideation With Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline -
Intent, No Plan Intent, No Plan you have these thoughts and had some intention of Ideation With Intent, No
C100982 CSS01-Ideation With CSS01-Ideation With Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline -
Plan/Intent Plan/Intent you started to work out or worked out the details of how Ideation With Plan/Intent
to kill yourself? Do you intend to carry out this plan?
C100983 CSS01-Ideation With CSS01-Ideation With Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Plan/Intent, Descr Plan/Intent, Descr Description of active suicidal ideation with specific plan Description of Ideation
C100995 CSS01-Interrupted CSS01-Interrupted Columbia-Suicide Severity Rating Scale Baseline - Has C-SSRS Baseline -
Attempt Attempt there been a time when you started to do something to Interrupted Suicide
try to end your life but someone or something stopped Attempt
C100997 CSS01-Interrupted CSS01-Interrupted Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Attempt, Describe Attempt, Describe Description of interrupted attempt. Description of Interrupted
Suicide Attempt
C101008 CSS01-Most Lethal CSS01-Most Lethal Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Attempt Damage Attempt Damage lethal attempt actual lethality/medical damage. Lethal Suicide Attempt
Damage
Attempt Date Attempt Date lethal attempt date. Lethal Suicide Attempt
Date
Attempt Potential Attempt Potential lethal attempt potential lethality. Lethal Suicide Attempt
Potential
C101005 CSS01-Most Recent CSS01-Most Recent Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Attempt Damage Attempt Damage recent attempt actual lethality/medical damage. Recent Suicide Attempt
Damage
Attempt Date Attempt Date recent attempt date. Recent Suicide Attempt
Date
Attempt Potential Attempt Potential recent attempt potential lethality. Recent Suicide Attempt
Potential
C100984 CSS01-Most Severe CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - Most C-SSRS Baseline - Most
Ideation Ideation severe ideation. Severe Ideation
page 231 of 1925

C100167 CSS01TN
Code Value
C100988 CSS01-Most Severe CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Ideation, Control Ideation, Control Could/can you stop thinking about killing yourself or Control over Most Severe
C100985 CSS01-Most Severe CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Ideation, Description Ideation, Description Description of most severe ideation. Describe Most Severe
Ideation
C100989 CSS01-Most Severe CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - Are C-SSRS Baseline -
Ideation, Deterrents Ideation, Deterrents there things - anyone or anything (e.g., family, religion, Deterrents to Most
C100987 CSS01-Most Severe CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - When C-SSRS Baseline -
Ideation, Duration Ideation, Duration you have the thoughts, how long do they last? Duration of Most Severe
Ideation
C100986 CSS01-Most Severe CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - How C-SSRS Baseline -
Ideation, Frequency Ideation, Frequency many times have you had these thoughts? Frequency of Most Severe
Ideation
C100990 CSS01-Most Severe CSS01-Most Severe Columbia-Suicide Severity Rating Scale Baseline - What C-SSRS Baseline -
Ideation, Reasons Ideation, Reasons sort of reasons did you have for thinking about wanting to Reasons for Most Severe
both?
C100979 CSS01-Non-Specific CSS01-Non-Specific Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Suicid Thought, Descr Suicid Thought, Descr Description of non-specific active suicidal thoughts. Description of Non-
C100978 CSS01-Non-Specific CSS01-Non-Specific Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline - Non-
Suicidal Thought Suicidal Thought you actually had any thoughts of killing yourself? Specific Suicidal Thought
C100994 CSS01-Non-suicidal Self- CSS01-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Baseline - Has the C-SSRS Baseline - Non-
injurious Behav injurious Behav subject engaged in non-suicidal self-injurious behavior. suicidal Self-injurious
Behavior
C100999 CSS01-Number of CSS01-Number of Columbia-Suicide Severity Rating Scale Baseline - Total C-SSRS Baseline -
Aborted Attempts Aborted Attempts number of aborted attempts. Number of Aborted
Suicide Attempts
C100992 CSS01-Number of Actual CSS01-Number of Actual Columbia-Suicide Severity Rating Scale Baseline - Total C-SSRS Baseline -
Attempts Attempts number of actual attempts. Number of Actual Suicide
Attempts
C100996 CSS01-Number of CSS01-Number of Columbia-Suicide Severity Rating Scale Baseline - Total C-SSRS Baseline -
Interrupted Attempts Interrupted Attempts number of interrupted attempts. Number of Interrupted
Suicide Attempts
C101001 CSS01-Preparatory CSS01-Preparatory Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline -
Acts/Behavior Acts/Behavior you taken any steps towards making a suicide attempt or Preparatory Acts or
C101002 CSS01-Preparatory CSS01-Preparatory Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Acts/Behavior, Descr Acts/Behavior, Descr Description of preparatory acts or behavior. Description of Preparatory
Suicide Attempt
C101003 CSS01-Suicidal Behavior CSS01-Suicidal Behavior Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
period?
C100980 CSS01-Suicidal Ideation- CSS01-Suicidal Ideation- Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline -
No Intent No Intent you been thinking about how you might do this? Suicidal Ideation-No
Intent
C100981 CSS01-Suicidal Ideation- CSS01-Suicidal Ideation- Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
No Intent, Descr No Intent, Descr Description of active suicidal ideation with any methods Description of Suicidal
C100976 CSS01-Wish to be Dead CSS01-Wish to be Dead Columbia-Suicide Severity Rating Scale Baseline - Have C-SSRS Baseline - Wish
you wished you were dead or wished you could go to to be Dead or go to Sleep
sleep and not wake up? and not Wake Up
C100977 CSS01-Wish to be Dead, CSS01-Wish to be Dead, Columbia-Suicide Severity Rating Scale Baseline - C-SSRS Baseline -
Describe Describe Description of wishing to be dead. Description of Wish to be
Dead
page 232 of 1925

CSS02TC (Columbia-Suicide Severity Rating Scale Since Last Visit Questionnaire Test Code)
C103461 CSS02TC
Code Value
C103772 CSS0201 CSS02-Wish to be Dead Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Have you wished you were dead or wished you could go Wish to be Dead or go to
to sleep and not wake up? Sleep and not Wake Up
C103773 CSS0201A CSS02-Wish to be Dead, Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Dead
C103774 CSS0202 CSS02-Non-Specific Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicidal Thought Have you actually had any thoughts of killing yourself? Non-Specific Suicidal
Thought
C103775 CSS0202A CSS02-Non-Specific Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicid Thought, Descr Description of non-specific active suicidal thoughts. Description of Non-
C103776 CSS0203 CSS02-Suicidal Ideation- Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
No Intent Have you been thinking about how you might do this? Suicidal Ideation-No
Intent
C103777 CSS0203A CSS02-Suicidal Ideation- Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
No Intent, Descr Description of active suicidal ideation with any methods Description of Suicidal
C103799 CSS0204 CSS02-Ideation With Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Intent, No Plan Have you had these thoughts and had some intention of Ideation With Intent, No
C103800 CSS0204A CSS02-Ideation With Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Intent No Plan Descr Description of active suicidal ideation with some intent to Description of Ideation
C103801 CSS0205 CSS02-Ideation With Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Plan/Intent Have you started to work out or worked out the details of Ideation With Plan/Intent
how to kill yourself? Do you intend to carry out this plan?
C103778 CSS0205A CSS02-Ideation With Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Plan/Intent, Descr Description of active suicidal ideation with specific plan Description of Ideation
C103779 CSS0206 CSS02-Most Severe Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Ideation Most severe ideation. Most Severe Ideation
C103780 CSS0206A CSS02-Most Severe Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Ideation, Description Description of most severe ideation. Describe Most Severe
Ideation
Ideation, Frequency How many times have you had these thoughts? Frequency of Most Severe
Ideation
Ideation, Duration When you have the thoughts, how long do they last? Duration of Most Severe
Ideation
Ideation, Control Could/can you stop thinking about killing yourself or Control over Most Severe
Ideation, Deterrents Are there things - anyone or anything (e.g., family, Deterrents to Most
religion, pain of death) - that stopped you from wanting Severe Ideation
to die or acting on thoughts of committing suicide?
Ideation, Reasons What sort of reasons did you have for thinking about Reasons for Most Severe
wanting to die or killing yourself? Was it to end the pain Ideation
or stop the way you were feeling (in other words you
couldn't go on living with this pain or how you were
feeling) or was it to get attention, revenge or a reaction
from others? Or both?
C103786 CSS0212 CSS02-Actual Attempt Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Have you made a suicide attempt? Have you done Actual Suicide Attempt
anything to harm yourself? Have you done anything
dangerous where you could have died?
C103787 CSS0213 CSS02-Number of Actual Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Attempts Total number of actual attempts. Number of Actual Suicide
Attempts
page 233 of 1925

C103461 CSS02TC
Code Value
C103788 CSS0213A CSS02-Actual Attempt, Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide Attempts
C103789 CSS0214 CSS02-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
injurious Behav Has the subject engaged in non-suicidal self-injurious Non-suicidal Self-
behavior. injurious Behavior
C103790 CSS0215 CSS02-Interrupted Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Attempt Has there been a time when you started to do something Interrupted Suicide
to try to end your life but someone or something stopped Attempt
C103791 CSS0216 CSS02-Number of Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Interrupted Attempts Total number of interrupted attempts. Number of Interrupted
Suicide Attempts
C103792 CSS0216A CSS02-Interrupted Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide Attempt
C103793 CSS0217 CSS02-Aborted Attempt Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Has there been a time when you started to do something Aborted Suicide Attempt
to try to end your life but you stopped yourself before you
C103794 CSS0218 CSS02-Number of Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Aborted Attempts Total number of aborted attempts. Number of Aborted
Suicide Attempts
C103795 CSS0218A CSS02-Aborted Attempt, Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide Attempt
C103796 CSS0219 CSS02-Preparatory Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Acts/Behavior Have you taken any steps towards making a suicide Preparatory Acts or
attempt or preparing to kill yourself (such as collecting Behaviors Toward Suicide
pills, getting a gun, giving valuables away or writing a Attempt
suicide note)?
C103797 CSS0219A CSS02-Preparatory Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide Attempt
C103798 CSS0220 CSS02-Suicidal Behavior Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
period?
C103532 CSS0221 CSS02-Suicide Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide. Suicide
C103533 CSS0222A CSS02-Most Lethal Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Attempt Date Most lethal attempt date. Most Lethal Attempt Date
C103534 CSS0222B CSS02-Most Lethal Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Attempt Damage Most lethal attempt actual lethality/medical damage. Most Lethal Actual
Attempt Lethality/Medical
Damage
C103535 CSS0222C CSS02-Most Lethal Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Attempt Potential Most lethal attempt potential lethality. Most Lethal Actual
Attempt Potential
Lethality
page 234 of 1925

CSS02TN (Columbia-Suicide Severity Rating Scale Since Last Visit Questionnaire Test Name)
C103460 CSS02TN
Code Value
C103793 CSS02-Aborted Attempt CSS02-Aborted Attempt Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Has there been a time when you started to do something Aborted Suicide Attempt
to try to end your life but you stopped yourself before you
C103795 CSS02-Aborted Attempt, CSS02-Aborted Attempt, Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide Attempt
C103786 CSS02-Actual Attempt CSS02-Actual Attempt Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Have you made a suicide attempt? Have you done Actual Suicide Attempt
anything to harm yourself? Have you done anything
dangerous where you could have died?
C103788 CSS02-Actual Attempt, CSS02-Actual Attempt, Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide Attempts
C103800 CSS02-Ideation With CSS02-Ideation With Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Intent No Plan Descr Intent No Plan Descr Description of active suicidal ideation with some intent to Description of Ideation
Intent, No Plan Intent, No Plan Have you had these thoughts and had some intention of Ideation With Intent, No
Plan/Intent Plan/Intent Have you started to work out or worked out the details of Ideation With Plan/Intent
how to kill yourself? Do you intend to carry out this plan?
Plan/Intent, Descr Plan/Intent, Descr Description of active suicidal ideation with specific plan Description of Ideation
C103790 CSS02-Interrupted CSS02-Interrupted Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Attempt Attempt Has there been a time when you started to do something Interrupted Suicide
to try to end your life but someone or something stopped Attempt
C103792 CSS02-Interrupted CSS02-Interrupted Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide Attempt
C103534 CSS02-Most Lethal CSS02-Most Lethal Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Attempt Damage Attempt Damage Most lethal attempt actual lethality/medical damage. Most Lethal Actual
Attempt Lethality/Medical
Damage
Attempt Date Attempt Date Most lethal attempt date. Most Lethal Attempt Date
Attempt Potential Attempt Potential Most lethal attempt potential lethality. Most Lethal Actual
Attempt Potential
Lethality
C103779 CSS02-Most Severe CSS02-Most Severe Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Ideation Ideation Most severe ideation. Most Severe Ideation
Ideation, Control Ideation, Control Could/can you stop thinking about killing yourself or Control over Most Severe
Ideation, Description Ideation, Description Description of most severe ideation. Describe Most Severe
Ideation
Ideation, Deterrents Ideation, Deterrents Are there things - anyone or anything (e.g., family, Deterrents to Most
religion, pain of death) - that stopped you from wanting Severe Ideation
to die or acting on thoughts of committing suicide?
Ideation, Duration Ideation, Duration When you have the thoughts, how long do they last? Duration of Most Severe
Ideation
Ideation, Frequency Ideation, Frequency How many times have you had these thoughts? Frequency of Most Severe
Ideation
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C103460 CSS02TN
Code Value
Ideation, Reasons Ideation, Reasons What sort of reasons did you have for thinking about Reasons for Most Severe
wanting to die or killing yourself? Was it to end the pain Ideation
or stop the way you were feeling (in other words you
from others? Or both?
C103775 CSS02-Non-Specific CSS02-Non-Specific Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicid Thought, Descr Suicid Thought, Descr Description of non-specific active suicidal thoughts. Description of Non-
C103774 CSS02-Non-Specific CSS02-Non-Specific Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicidal Thought Suicidal Thought Have you actually had any thoughts of killing yourself? Non-Specific Suicidal
Thought
C103789 CSS02-Non-suicidal Self- CSS02-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
injurious Behav injurious Behav Has the subject engaged in non-suicidal self-injurious Non-suicidal Self-
behavior. injurious Behavior
C103794 CSS02-Number of CSS02-Number of Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Aborted Attempts Aborted Attempts Total number of aborted attempts. Number of Aborted
Suicide Attempts
C103787 CSS02-Number of Actual CSS02-Number of Actual Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Attempts Attempts Total number of actual attempts. Number of Actual Suicide
Attempts
C103791 CSS02-Number of CSS02-Number of Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Interrupted Attempts Interrupted Attempts Total number of interrupted attempts. Number of Interrupted
Suicide Attempts
C103796 CSS02-Preparatory CSS02-Preparatory Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Acts/Behavior Acts/Behavior Have you taken any steps towards making a suicide Preparatory Acts or
attempt or preparing to kill yourself (such as collecting Behaviors Toward Suicide
pills, getting a gun, giving valuables away or writing a Attempt
suicide note)?
C103797 CSS02-Preparatory CSS02-Preparatory Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide Attempt
C103798 CSS02-Suicidal Behavior CSS02-Suicidal Behavior Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
period?
C103776 CSS02-Suicidal Ideation- CSS02-Suicidal Ideation- Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
No Intent No Intent Have you been thinking about how you might do this? Suicidal Ideation-No
Intent
C103777 CSS02-Suicidal Ideation- CSS02-Suicidal Ideation- Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
No Intent, Descr No Intent, Descr Description of active suicidal ideation with any methods Description of Suicidal
C103532 CSS02-Suicide CSS02-Suicide Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Suicide. Suicide
C103772 CSS02-Wish to be Dead CSS02-Wish to be Dead Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Have you wished you were dead or wished you could go Wish to be Dead or go to
to sleep and not wake up? Sleep and not Wake Up
C103773 CSS02-Wish to be Dead, CSS02-Wish to be Dead, Columbia-Suicide Severity Rating Scale Since Last Visit - C-SSRS Since Last Visit -
Dead
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CSS03TC (Columbia-Suicide Severity Rating Scale Baseline/Screening Version Phase 1 Study
C105132 CSS03TC
Code Value
C105210 CSS0301A CSS03-Wish to be Dead- Columbia-Suicide Severity Rating Scale C-SSRS

Life Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
wished you were dead or wished you could go to sleep Version Phase 1 Study -
and not wake up? (Lifetime). Wish to be Dead
(Lifetime)
C105211 CSS0301B CSS03-Wish to be Dead- Columbia-Suicide Severity Rating Scale C-SSRS

P6M Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
and not wake up? (Past 6 Months). Wish to be Dead (Past 6
Months)
C105212 CSS0301C CSS03-Wish to be Dead, Columbia-Suicide Severity Rating Scale C-SSRS

Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of wishing to be dead. Version Phase 1 Study -
Description of Wish to be
Dead (Lifetime)
C105213 CSS0302A CSS03-Non-Spec Suicid Columbia-Suicide Severity Rating Scale C-SSRS

Thought-Life Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
actually had any thoughts of killing yourself? (Lifetime). Version Phase 1 Study -
Non-Specific Active
Suicidal Thoughts
(Lifetime)
C105214 CSS0302B CSS03-Non-Spec Suicid Columbia-Suicide Severity Rating Scale C-SSRS

Thought-P6M Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
actually had any thoughts of killing yourself? (Past 6 Version Phase 1 Study -
Months). Non-Specific Active
Suicidal Thoughts (Past 6
Months)
C105215 CSS0302C CSS03-Non-Spec Suicid Columbia-Suicide Severity Rating Scale C-SSRS

Thought, Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of non-specific active suicidal thoughts. Version Phase 1 Study -
Description of Non-
Specific Active Suicidal
Thoughts (Lifetime)
C105216 CSS0303A CSS03-Idea, No Intent, Columbia-Suicide Severity Rating Scale C-SSRS

No Plan-Life Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
been thinking about how you might do this? (Lifetime). Version Phase 1 Study -
Active Suicidal Ideation
with Any Methods (Not
Plan) without Intent to
Act (Lifetime)
C105217 CSS0303B CSS03-Idea, No Intent, Columbia-Suicide Severity Rating Scale C-SSRS

No Plan-P6M Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
been thinking about how you might do this? (Past 6 Version Phase 1 Study -
Months). Active Suicidal Ideation
Act (Past 6 Months)
C105218 CSS0303C CSS03-Idea, No Intent, Columbia-Suicide Severity Rating Scale C-SSRS

No Plan, Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of active suicidal ideation with any methods (not plan) Version Phase 1 Study -
without intent to act. Description of Active
Suicidal Ideation with Any
Methods (Not Plan)
without Intent to Act
(Lifetime)
C105219 CSS0304A CSS03-Idea, Intent, No Columbia-Suicide Severity Rating Scale C-SSRS

Plan-Life Baseline/Screening Version Phase 1 Study - Have you had Baseline/Screening
these thoughts and had some intention of acting on Version Phase 1 Study -
them? (Lifetime). Active Suicidal Ideation
with Some Intent to Act,
without Specific Plan
(Lifetime)
C105220 CSS0304B CSS03-Idea, Intent, No Columbia-Suicide Severity Rating Scale C-SSRS

Plan-P6M Baseline/Screening Version Phase 1 Study - Have you had Baseline/Screening
them? (Past 6 Months). Active Suicidal Ideation
(Past 6 Months)
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C105132 CSS03TC
Code Value
C105221 CSS0304C CSS03-Idea, Intent, No Columbia-Suicide Severity Rating Scale C-SSRS

Plan, Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of active suicidal ideation with some intent to act, without Version Phase 1 Study -
specific plan. Description of Active
Suicidal Ideation with
Some Intent to Act,
(Lifetime)
C105222 CSS0305A CSS03-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale C-SSRS
Life Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
started to work out or worked out the details of how to Version Phase 1 Study -
kill yourself? Do you intend to carry out this plan? Active Suicidal Ideation
(Lifetime). with Specific Plan and
Intent (Lifetime)
C105223 CSS0305B CSS03-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale C-SSRS
P6M Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
kill yourself? Do you intend to carry out this plan? (Past 6 Active Suicidal Ideation
Months). with Specific Plan and
Intent (Past 6 Months)
C105224 CSS0305C CSS03-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale C-SSRS
of active suicidal ideation with specific plan and intent. Version Phase 1 Study -
Description of Active
Specific Plan and Intent
(Lifetime)
C105225 CSS0306A CSS03-Most Severe Idea- Columbia-Suicide Severity Rating Scale C-SSRS
Life Baseline/Screening Version Phase 1 Study - Most severe Baseline/Screening
ideation. (Lifetime). Version Phase 1 Study -
Most Severe Ideation
(Lifetime)
C105226 CSS0306B CSS03-Most Severe Idea, Columbia-Suicide Severity Rating Scale C-SSRS
Desc-Life Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of most severe ideation. (Lifetime). Version Phase 1 Study -
Describe Most Severe
Ideation (Lifetime)
C105227 CSS0306C CSS03-Most Severe Idea- Columbia-Suicide Severity Rating Scale C-SSRS
P6M Baseline/Screening Version Phase 1 Study - Most severe Baseline/Screening
ideation. (Past 6 Months). Version Phase 1 Study -
(Past 6 Months)
C105228 CSS0306D CSS03-Most Severe Idea, Columbia-Suicide Severity Rating Scale C-SSRS
Desc-P6M Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of most severe ideation. (Past 6 Months). Version Phase 1 Study -
Ideation (Past 6 Months)
C105229 CSS0307A CSS03-Most Severe Idea, Columbia-Suicide Severity Rating Scale C-SSRS
Frequency-Life Baseline/Screening Version Phase 1 Study - How many Baseline/Screening
times have you had these thoughts? (Lifetime). Version Phase 1 Study -
Frequency of Most Severe
Ideation (Lifetime)
Frequency-P6M Baseline/Screening Version Phase 1 Study - How many Baseline/Screening
times have you had these thoughts? (Past 6 Months). Version Phase 1 Study -
Duration-Life Baseline/Screening Version Phase 1 Study - When you Baseline/Screening
have the thoughts how long do they last? (Lifetime). Version Phase 1 Study -
Duration of Most Severe
Ideation (Lifetime)
Duration-P6M Baseline/Screening Version Phase 1 Study - When you Baseline/Screening
have the thoughts how long do they last? (Past 6 Version Phase 1 Study -
Months). Duration of Most Severe
Control-Life Baseline/Screening Version Phase 1 Study - Could/can Baseline/Screening
you stop thinking about killing yourself or wanting to die Version Phase 1 Study -
if you want to? (Lifetime). Controllability of Most
Severe Ideation
(Lifetime)
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C105132 CSS03TC
Code Value
Control-P6M Baseline/Screening Version Phase 1 Study - Could/can Baseline/Screening
if you want to? (Past 6 Months). Controllability of Most
Severe Ideation (Past 6
Months)
Deterrents-Life Baseline/Screening Version Phase 1 Study - Are there Baseline/Screening
things-anyone or anything (e.g., family, religion, pain of Version Phase 1 Study -
death) - that stopped you from wanting to die or acting Deterrents to Most
on thoughts of committing suicide? (Lifetime). Severe Ideation
(Lifetime)
Deterrents-P6M Baseline/Screening Version Phase 1 Study - Are there Baseline/Screening
on thoughts of committing suicide? (Past 6 Months). Severe Ideation (Past 6
Months)
Reasons-Life Baseline/Screening Version Phase 1 Study - What sort of Baseline/Screening
reasons did you have for thinking about wanting to die or Version Phase 1 Study -
killing yourself? Was it to end the pain or stop the way Reasons for Most Severe
you were feeling (in other words you couldn't go on living Ideation (Lifetime)
with this pain or how you were feeling) or was it to get
attention, revenge or a reaction from others? Or both?
(Lifetime).
Reasons-P6M Baseline/Screening Version Phase 1 Study - What sort of Baseline/Screening
you were feeling (in other words you couldn't go on living Ideation (Past 6 Months)
(Past 6 Months).
C105239 CSS0312 CSS03-Actual Attempt Columbia-Suicide Severity Rating Scale C-SSRS

Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
made a suicide attempt? Have you done anything to harm Version Phase 1 Study -
yourself? Have you done anything dangerous where you Actual Suicide Attempt
could have died?
C105240 CSS0313 CSS03-Number of Actual Columbia-Suicide Severity Rating Scale C-SSRS

Attempts Baseline/Screening Version Phase 1 Study - Total number Baseline/Screening
of actual attempts. Version Phase 1 Study -
Number of Actual Suicide
Attempts
C105241 CSS0313A CSS03-Actual Attempt, Columbia-Suicide Severity Rating Scale C-SSRS

of actual attempt. Version Phase 1 Study -
Description of Actual
Suicide Attempt
C105242 CSS0314 CSS03-Non-suicidal Self- Columbia-Suicide Severity Rating Scale C-SSRS

injurious Behav Baseline/Screening Version Phase 1 Study - Has the Baseline/Screening
subject engaged in non-suicidal self-injurious behavior. Version Phase 1 Study -
Non-suicidal Self-
injurious Behavior
C105243 CSS0315 CSS03-Interrupted Columbia-Suicide Severity Rating Scale C-SSRS

Attempt Baseline/Screening Version Phase 1 Study - Has there Baseline/Screening
been a time when you started to do something to try to Version Phase 1 Study -
end your life but someone or something stopped you Interrupted Suicide
before you actually did anything? Attempt
C105244 CSS0316 CSS03-Number of Columbia-Suicide Severity Rating Scale C-SSRS

Interrupted Attempts Baseline/Screening Version Phase 1 Study - Total number Baseline/Screening
of interrupted attempts. Version Phase 1 Study -
Number of Interrupted
Suicide Attempts
C105245 CSS0316A CSS03-Interrupted Columbia-Suicide Severity Rating Scale C-SSRS

Attempt, Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of interrupted attempt. Version Phase 1 Study -
Description of Interrupted
Suicide Attempt
page 239 of 1925

C105132 CSS03TC
Code Value
C105246 CSS0317 CSS03-Aborted Attempt Columbia-Suicide Severity Rating Scale C-SSRS

Baseline/Screening Version Phase 1 Study - Has there Baseline/Screening
end your life but you stopped yourself before you actually Aborted Suicide Attempt
did anything?
C105247 CSS0318 CSS03-Number of Columbia-Suicide Severity Rating Scale C-SSRS

Aborted Attempts Baseline/Screening Version Phase 1 Study - Total number Baseline/Screening
of aborted attempts. Version Phase 1 Study -
Number of Aborted
Suicide Attempts
C105248 CSS0318A CSS03-Aborted Attempt, Columbia-Suicide Severity Rating Scale C-SSRS

of aborted attempt. Version Phase 1 Study -
Description of Aborted
Suicide Attempt
C105249 CSS0319 CSS03-Preparatory Columbia-Suicide Severity Rating Scale C-SSRS

Acts/Behavior Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
taken any steps towards making a suicide attempt or Version Phase 1 Study -
preparing to kill yourself (such as collecting pills, getting Preparatory Acts or
a gun, giving valuables away or writing a suicide note)? Behaviors Toward Suicide
Attempt
C105250 CSS0319A CSS03-Preparatory Columbia-Suicide Severity Rating Scale C-SSRS

Acts/Behavior, Descr Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of preparatory acts or behavior. Version Phase 1 Study -
Description of Preparatory
Suicide Attempt
C105251 CSS0320 CSS03-Suicidal Behavior Columbia-Suicide Severity Rating Scale C-SSRS

Baseline/Screening Version Phase 1 Study - Suicidal Baseline/Screening
behavior was present during the assessment period? Version Phase 1 Study -
Suicidal Behavior
C105252 CSS0321A CSS03-Most Recent Columbia-Suicide Severity Rating Scale C-SSRS

Attempt Date Baseline/Screening Version Phase 1 Study - Most recent Baseline/Screening
attempt date. Version Phase 1 Study -
Most Recent Suicide
Attempt Date
C105253 CSS0321B CSS03-Most Recent Columbia-Suicide Severity Rating Scale C-SSRS

Attempt Damage Baseline/Screening Version Phase 1 Study - Most recent Baseline/Screening
attempt actual lethality/medical damage. Version Phase 1 Study -
Most Recent Suicide
Attempt Actual
Lethality/Medical Damage
C105254 CSS0321C CSS03-Most Recent Columbia-Suicide Severity Rating Scale C-SSRS

Attempt Potential Baseline/Screening Version Phase 1 Study - Most recent Baseline/Screening
attempt potential lethality. Version Phase 1 Study -
Most Recent Suicide
Attempt Potential
Lethality
C105255 CSS0322A CSS03-Most Lethal Columbia-Suicide Severity Rating Scale C-SSRS

Attempt Date Baseline/Screening Version Phase 1 Study - Most lethal Baseline/Screening
Most Lethal Suicide
Attempt Date
C105256 CSS0322B CSS03-Most Lethal Columbia-Suicide Severity Rating Scale C-SSRS

Attempt Damage Baseline/Screening Version Phase 1 Study - Most lethal Baseline/Screening
Most Lethal Suicide
Attempt Actual
C105257 CSS0322C CSS03-Most Lethal Columbia-Suicide Severity Rating Scale C-SSRS

Attempt Potential Baseline/Screening Version Phase 1 Study - Most lethal Baseline/Screening
Most Lethal Suicide
Attempt Potential
Lethality
C105258 CSS0323A CSS03-First Attempt Date Columbia-Suicide Severity Rating Scale C-SSRS
Baseline/Screening Version Phase 1 Study - Initial/first Baseline/Screening
First Suicide Attempt
Date
page 240 of 1925

C105132 CSS03TC
Code Value
C105259 CSS0323B CSS03-First Attempt Columbia-Suicide Severity Rating Scale C-SSRS

Damage Baseline/Screening Version Phase 1 Study - Initial/first Baseline/Screening
Actual Lethality/Medical
Damage
C105260 CSS0323C CSS03-First Attempt Columbia-Suicide Severity Rating Scale C-SSRS

Potential Baseline/Screening Version Phase 1 Study - Initial/first Baseline/Screening
Potential Lethality
page 241 of 1925

CSS03TN (Columbia-Suicide Severity Rating Scale Baseline/Screening Version Phase 1 Study
C105131 CSS03TN
Code Value
C105246 CSS03-Aborted Attempt CSS03-Aborted Attempt Columbia-Suicide Severity Rating Scale C-SSRS
Baseline/Screening Version Phase 1 Study - Has there Baseline/Screening
end your life but you stopped yourself before you actually Aborted Suicide Attempt
did anything?
C105248 CSS03-Aborted Attempt, CSS03-Aborted Attempt, Columbia-Suicide Severity Rating Scale C-SSRS
Describe Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of aborted attempt. Version Phase 1 Study -
Suicide Attempt
C105239 CSS03-Actual Attempt CSS03-Actual Attempt Columbia-Suicide Severity Rating Scale C-SSRS
Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
made a suicide attempt? Have you done anything to harm Version Phase 1 Study -
yourself? Have you done anything dangerous where you Actual Suicide Attempt
could have died?
C105241 CSS03-Actual Attempt, CSS03-Actual Attempt, Columbia-Suicide Severity Rating Scale C-SSRS
of actual attempt. Version Phase 1 Study -
Suicide Attempt
C105259 CSS03-First Attempt CSS03-First Attempt Columbia-Suicide Severity Rating Scale C-SSRS
Damage Damage Baseline/Screening Version Phase 1 Study - Initial/first Baseline/Screening
Damage
C105258 CSS03-First Attempt Date CSS03-First Attempt Date Columbia-Suicide Severity Rating Scale C-SSRS
Baseline/Screening Version Phase 1 Study - Initial/first Baseline/Screening
Date
Potential Potential Baseline/Screening Version Phase 1 Study - Initial/first Baseline/Screening
Potential Lethality
C105221 CSS03-Idea, Intent, No CSS03-Idea, Intent, No Columbia-Suicide Severity Rating Scale C-SSRS
Plan, Describe Plan, Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of active suicidal ideation with some intent to act, without Version Phase 1 Study -
specific plan. Description of Active
Some Intent to Act,
(Lifetime)
Plan-Life Plan-Life Baseline/Screening Version Phase 1 Study - Have you had Baseline/Screening
them? (Lifetime). Active Suicidal Ideation
(Lifetime)
Plan-P6M Plan-P6M Baseline/Screening Version Phase 1 Study - Have you had Baseline/Screening
them? (Past 6 Months). Active Suicidal Ideation
(Past 6 Months)
C105218 CSS03-Idea, No Intent, CSS03-Idea, No Intent, Columbia-Suicide Severity Rating Scale C-SSRS
No Plan, Describe No Plan, Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of active suicidal ideation with any methods (not plan) Version Phase 1 Study -
without intent to act. Description of Active
Suicidal Ideation with Any
Methods (Not Plan)
(Lifetime)
page 242 of 1925

C105131 CSS03TN
Code Value
No Plan-Life No Plan-Life Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
been thinking about how you might do this? (Lifetime). Version Phase 1 Study -
Act (Lifetime)
No Plan-P6M No Plan-P6M Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
been thinking about how you might do this? (Past 6 Version Phase 1 Study -
Months). Active Suicidal Ideation
Act (Past 6 Months)
C105224 CSS03-Idea, Plan, Intent, CSS03-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale C-SSRS
of active suicidal ideation with specific plan and intent. Version Phase 1 Study -
Description of Active
(Lifetime)
C105222 CSS03-Idea, Plan, Intent- CSS03-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale C-SSRS
Life Life Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
kill yourself? Do you intend to carry out this plan? Active Suicidal Ideation
(Lifetime). with Specific Plan and
Intent (Lifetime)
P6M P6M Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
kill yourself? Do you intend to carry out this plan? (Past 6 Active Suicidal Ideation
Months). with Specific Plan and
Intent (Past 6 Months)
C105243 CSS03-Interrupted CSS03-Interrupted Columbia-Suicide Severity Rating Scale C-SSRS

Attempt Attempt Baseline/Screening Version Phase 1 Study - Has there Baseline/Screening
end your life but someone or something stopped you Interrupted Suicide
before you actually did anything? Attempt

Attempt, Describe Attempt, Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of interrupted attempt. Version Phase 1 Study -
Suicide Attempt
C105256 CSS03-Most Lethal CSS03-Most Lethal Columbia-Suicide Severity Rating Scale C-SSRS
Attempt Damage Attempt Damage Baseline/Screening Version Phase 1 Study - Most lethal Baseline/Screening
Most Lethal Suicide
Attempt Actual
Attempt Date Attempt Date Baseline/Screening Version Phase 1 Study - Most lethal Baseline/Screening
Most Lethal Suicide
Attempt Date
Attempt Potential Attempt Potential Baseline/Screening Version Phase 1 Study - Most lethal Baseline/Screening
Most Lethal Suicide
Attempt Potential
Lethality
C105253 CSS03-Most Recent CSS03-Most Recent Columbia-Suicide Severity Rating Scale C-SSRS
Attempt Damage Attempt Damage Baseline/Screening Version Phase 1 Study - Most recent Baseline/Screening
Most Recent Suicide
Attempt Actual
Attempt Date Attempt Date Baseline/Screening Version Phase 1 Study - Most recent Baseline/Screening
Most Recent Suicide
Attempt Date
page 243 of 1925

C105131 CSS03TN
Code Value
Attempt Potential Attempt Potential Baseline/Screening Version Phase 1 Study - Most recent Baseline/Screening
Most Recent Suicide
Attempt Potential
Lethality
C105233 CSS03-Most Severe Idea, CSS03-Most Severe Idea, Columbia-Suicide Severity Rating Scale C-SSRS
Control-Life Control-Life Baseline/Screening Version Phase 1 Study - Could/can Baseline/Screening
if you want to? (Lifetime). Controllability of Most
Severe Ideation
(Lifetime)
Control-P6M Control-P6M Baseline/Screening Version Phase 1 Study - Could/can Baseline/Screening
if you want to? (Past 6 Months). Controllability of Most
Months)
Desc-Life Desc-Life Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of most severe ideation. (Lifetime). Version Phase 1 Study -
Ideation (Lifetime)
Desc-P6M Desc-P6M Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of most severe ideation. (Past 6 Months). Version Phase 1 Study -
Deterrents-Life Deterrents-Life Baseline/Screening Version Phase 1 Study - Are there Baseline/Screening
on thoughts of committing suicide? (Lifetime). Severe Ideation
(Lifetime)
Deterrents-P6M Deterrents-P6M Baseline/Screening Version Phase 1 Study - Are there Baseline/Screening
on thoughts of committing suicide? (Past 6 Months). Severe Ideation (Past 6
Months)
Duration-Life Duration-Life Baseline/Screening Version Phase 1 Study - When you Baseline/Screening
have the thoughts how long do they last? (Lifetime). Version Phase 1 Study -
Duration of Most Severe
Ideation (Lifetime)
Duration-P6M Duration-P6M Baseline/Screening Version Phase 1 Study - When you Baseline/Screening
have the thoughts how long do they last? (Past 6 Version Phase 1 Study -
Months). Duration of Most Severe
Frequency-Life Frequency-Life Baseline/Screening Version Phase 1 Study - How many Baseline/Screening
times have you had these thoughts? (Lifetime). Version Phase 1 Study -
Ideation (Lifetime)
Frequency-P6M Frequency-P6M Baseline/Screening Version Phase 1 Study - How many Baseline/Screening
times have you had these thoughts? (Past 6 Months). Version Phase 1 Study -
Reasons-Life Reasons-Life Baseline/Screening Version Phase 1 Study - What sort of Baseline/Screening
you were feeling (in other words you couldn't go on living Ideation (Lifetime)
(Lifetime).
page 244 of 1925

C105131 CSS03TN
Code Value
Reasons-P6M Reasons-P6M Baseline/Screening Version Phase 1 Study - What sort of Baseline/Screening
you were feeling (in other words you couldn't go on living Ideation (Past 6 Months)
(Past 6 Months).
C105225 CSS03-Most Severe Idea- CSS03-Most Severe Idea- Columbia-Suicide Severity Rating Scale C-SSRS
Life Life Baseline/Screening Version Phase 1 Study - Most severe Baseline/Screening
ideation. (Lifetime). Version Phase 1 Study -
(Lifetime)
P6M P6M Baseline/Screening Version Phase 1 Study - Most severe Baseline/Screening
ideation. (Past 6 Months). Version Phase 1 Study -
(Past 6 Months)
C105215 CSS03-Non-Spec Suicid CSS03-Non-Spec Suicid Columbia-Suicide Severity Rating Scale C-SSRS
Thought, Describe Thought, Describe Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of non-specific active suicidal thoughts. Version Phase 1 Study -
Description of Non-
Thoughts (Lifetime)
Thought-Life Thought-Life Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
actually had any thoughts of killing yourself? (Lifetime). Version Phase 1 Study -
Non-Specific Active
Suicidal Thoughts
(Lifetime)
Thought-P6M Thought-P6M Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
actually had any thoughts of killing yourself? (Past 6 Version Phase 1 Study -
Months). Non-Specific Active
Suicidal Thoughts (Past 6
Months)
C105242 CSS03-Non-suicidal Self- CSS03-Non-suicidal Self- Columbia-Suicide Severity Rating Scale C-SSRS
injurious Behav injurious Behav Baseline/Screening Version Phase 1 Study - Has the Baseline/Screening
subject engaged in non-suicidal self-injurious behavior. Version Phase 1 Study -
Non-suicidal Self-
injurious Behavior
C105247 CSS03-Number of CSS03-Number of Columbia-Suicide Severity Rating Scale C-SSRS

Aborted Attempts Aborted Attempts Baseline/Screening Version Phase 1 Study - Total number Baseline/Screening
of aborted attempts. Version Phase 1 Study -
Number of Aborted
Suicide Attempts
C105240 CSS03-Number of Actual CSS03-Number of Actual Columbia-Suicide Severity Rating Scale C-SSRS
Attempts Attempts Baseline/Screening Version Phase 1 Study - Total number Baseline/Screening
of actual attempts. Version Phase 1 Study -
Attempts

Interrupted Attempts Interrupted Attempts Baseline/Screening Version Phase 1 Study - Total number Baseline/Screening
of interrupted attempts. Version Phase 1 Study -
Number of Interrupted
Suicide Attempts
C105249 CSS03-Preparatory CSS03-Preparatory Columbia-Suicide Severity Rating Scale C-SSRS

Acts/Behavior Acts/Behavior Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
taken any steps towards making a suicide attempt or Version Phase 1 Study -
preparing to kill yourself (such as collecting pills, getting Preparatory Acts or
a gun, giving valuables away or writing a suicide note)? Behaviors Toward Suicide
Attempt

Acts/Behavior, Descr Acts/Behavior, Descr Baseline/Screening Version Phase 1 Study - Description Baseline/Screening
of preparatory acts or behavior. Version Phase 1 Study -
Description of Preparatory
Suicide Attempt
C105251 CSS03-Suicidal Behavior CSS03-Suicidal Behavior Columbia-Suicide Severity Rating Scale C-SSRS
Baseline/Screening Version Phase 1 Study - Suicidal Baseline/Screening
behavior was present during the assessment period? Version Phase 1 Study -
Suicidal Behavior
page 245 of 1925

C105131 CSS03TN
Code Value
C105212 CSS03-Wish to be Dead, CSS03-Wish to be Dead, Columbia-Suicide Severity Rating Scale C-SSRS
of wishing to be dead. Version Phase 1 Study -
Dead (Lifetime)
C105210 CSS03-Wish to be Dead- CSS03-Wish to be Dead- Columbia-Suicide Severity Rating Scale C-SSRS
Life Life Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
and not wake up? (Lifetime). Wish to be Dead
(Lifetime)
P6M P6M Baseline/Screening Version Phase 1 Study - Have you Baseline/Screening
and not wake up? (Past 6 Months). Wish to be Dead (Past 6
Months)
page 246 of 1925

CSS04TC (Columbia-Suicide Severity Rating Scale Baseline/Screening Version Questionnaire Test
Code)
C106661 CSS04TC
Code Value

Life Baseline/Screening Version - Have you wished you were Baseline/Screening
dead or wished you could go to sleep and not wake up? Version - Wish to be Dead
(Lifetime). (Lifetime)

P_M Baseline/Screening Version - Have you wished you were Baseline/Screening
(Past _ Months). (Past X Months)

Describe Baseline/Screening Version - Description of wishing to be Baseline/Screening
dead. Version - Description of
Wish to be Dead

Thought-Life Baseline/Screening Version - Have you actually had any Baseline/Screening
thoughts of killing yourself? (Lifetime). Version - Non-Specific
Active Suicidal Thoughts
(Lifetime)

Thought-P_M Baseline/Screening Version - Have you actually had any Baseline/Screening
thoughts of killing yourself? (Past _ Months). Version - Non-Specific
(Past X Months)

Thought, Describe Baseline/Screening Version - Description of non-specific Baseline/Screening
active suicidal thoughts. Version - Description of
Non-Specific Active
Suicidal Thoughts

No Plan-Life Baseline/Screening Version - Have you been thinking Baseline/Screening
about how you might do this? (Lifetime). Version - Active Suicidal
Ideation with Any
Methods (Not Plan)
(Lifetime)

No Plan-P_M Baseline/Screening Version - Have you been thinking Baseline/Screening
about how you might do this? (Past _ Months). Version - Active Suicidal
Ideation with Any
Methods (Not Plan)
(Past X Months)

No Plan, Describe Baseline/Screening Version - Description of active suicidal Baseline/Screening
ideation with any methods (not plan) without intent to Version - Description of
act. Active Suicidal Ideation
Act

Plan-Life Baseline/Screening Version - Have you had these Baseline/Screening
thoughts and had some intention of acting on them? Version - Active Suicidal
(Lifetime). Ideation with Some
Intent to Act, without
Specific Plan (Lifetime)

Plan-P_M Baseline/Screening Version - Have you had these Baseline/Screening
(Past _ Months). Ideation with Some
Specific Plan (Past X
Months)

Plan, Describe Baseline/Screening Version - Description of active suicidal Baseline/Screening
ideation with some intent to act, without specific plan. Version - Description of
page 247 of 1925

C106661 CSS04TC
Code Value
Life Baseline/Screening Version - Have you started to work Baseline/Screening
out or worked out the details of how to kill yourself? Do Version - Active Suicidal
you intend to carry out this plan? (Lifetime). Ideation with Specific
Plan and Intent (Lifetime)
P_M Baseline/Screening Version - Have you started to work Baseline/Screening
you intend to carry out this plan? (Past _ Months). Ideation with Specific
Plan and Intent (Past X
Months)
Describe Baseline/Screening Version - Description of active suicidal Baseline/Screening
ideation with specific plan and intent. Version - Description of
with Specific Plan and
Intent
Life Baseline/Screening Version - Most severe ideation. Baseline/Screening
(Lifetime). Version - Most Severe
Ideation (Lifetime)
Desc-Life Baseline/Screening Version - Description of most severe Baseline/Screening
ideation. (Lifetime). Version - Describe Most
Severe Ideation
(Lifetime)
P_M Baseline/Screening Version - Most severe ideation. (Past Baseline/Screening
_ Months). Version - Most Severe
Ideation (Past X Months)
Desc-P_M Baseline/Screening Version - Description of most severe Baseline/Screening
ideation. (Past _ Months). Version - Describe Most
Severe Ideation (Past X
Months)
Frequency-Life Baseline/Screening Version - How many times have you Baseline/Screening
had these thoughts? (Lifetime). Version - Frequency of
(Lifetime)
Frequency-P_M Baseline/Screening Version - How many times have you Baseline/Screening
had these thoughts? (Past _ Months). Version - Frequency of
(Past X Months)
Duration-Life Baseline/Screening Version - When you have the Baseline/Screening
thoughts how long do they last? (Lifetime). Version - Duration of
(Lifetime)
Duration-P_M Baseline/Screening Version - When you have the Baseline/Screening
thoughts how long do they last? (Past _ Months). Version - Duration of
(Past X Months)
Control-Life Baseline/Screening Version - Could/can you stop thinking Baseline/Screening
about killing yourself or wanting to die if you want to? Version - Controllability of
(Lifetime). Most Severe Ideation
(Lifetime)
Control-P_M Baseline/Screening Version - Could/can you stop thinking Baseline/Screening
(Past _ Months). Most Severe Ideation
(Past X Months)
Deterrents-Life Baseline/Screening Version - Are there things-anyone or Baseline/Screening
anything (e.g., family, religion, pain of death) - that Version - Deterrents to
stopped you from wanting to die or acting on thoughts of Most Severe Ideation
committing suicide? (Lifetime). (Lifetime)
page 248 of 1925

C106661 CSS04TC
Code Value
Deterrents-P_M Baseline/Screening Version - Are there things-anyone or Baseline/Screening
committing suicide? (Past _ Months). (Past X Months)
Reasons-Life Baseline/Screening Version - What sort of reasons did Baseline/Screening
you have for thinking about wanting to die or killing Version - Reasons for
yourself? Was it to end the pain or stop the way you were Most Severe Ideation
feeling (in other words you couldn't go on living with this (Lifetime)
pain or how you were feeling) or was it to get attention,
revenge or a reaction from others? Or both? (Lifetime).
Reasons-P_M Baseline/Screening Version - What sort of reasons did Baseline/Screening
feeling (in other words you couldn't go on living with this (Past X Months)
revenge or a reaction from others? Or both? (Past _
Months).
C106733 CSS0412A CSS04-Actual Attempt- Columbia-Suicide Severity Rating Scale C-SSRS

Life Baseline/Screening Version - Have you made a suicide Baseline/Screening
attempt? Have you done anything to harm yourself? Have Version - Actual Suicide
you done anything dangerous where you could have Attempt (Lifetime)
died? (Lifetime).
C106734 CSS0412B CSS04-Actual Attempt- Columbia-Suicide Severity Rating Scale C-SSRS

P_Y Baseline/Screening Version - Have you made a suicide Baseline/Screening
you done anything dangerous where you could have Attempt (Past X Years)
died? (Past _ Years).
C106735 CSS0413A CSS04-Number of Actual Columbia-Suicide Severity Rating Scale C-SSRS

Attempts-Life Baseline/Screening Version - Total number of actual Baseline/Screening
attempts. (Lifetime). Version - Number of
Actual Suicide Attempts
(Lifetime)
C106736 CSS0413B CSS04-Number of Actual Columbia-Suicide Severity Rating Scale C-SSRS

Attempts-P_Y Baseline/Screening Version - Total number of actual Baseline/Screening
attempts. (Past _ Years). Version - Number of
(Past X Years)
C106737 CSS0413C CSS04-Actual Attempt, Columbia-Suicide Severity Rating Scale C-SSRS

Describe Baseline/Screening Version - Description of actual Baseline/Screening
attempt. Version - Description of
Actual Suicide Attempt
C106738 CSS0414A CSS04-Non-suicidal Self- Columbia-Suicide Severity Rating Scale C-SSRS

injur Behav-Life Baseline/Screening Version - Has the subject engaged in Baseline/Screening
non-suicidal self-injurious behavior. (Lifetime). Version - Non-suicidal
Self-injurious Behavior
(Lifetime)
C106739 CSS0414B CSS04-Non-suicidal Self- Columbia-Suicide Severity Rating Scale C-SSRS

injur Behav-P_Y Baseline/Screening Version - Has the subject engaged in Baseline/Screening
non-suicidal self-injurious behavior. (Past _ Years). Version - Non-suicidal
(Past X Years)

Attempt-Life Baseline/Screening Version - Has there been a time when Baseline/Screening
you started to do something to try to end your life but Version - Interrupted
someone or something stopped you before you actually Suicide Attempt
did anything? (Lifetime). (Lifetime)
C106741 CSS0415B CSS04-Interrupted Columbia-Suicide Severity Rating Scale C-SSRS

Attempt-P_Y Baseline/Screening Version - Has there been a time when Baseline/Screening
someone or something stopped you before you actually Suicide Attempt (Past X
did anything? (Past _ Years). Years)
C106742 CSS0416A CSS04-Number of Columbia-Suicide Severity Rating Scale C-SSRS

Interrupt Attempts-Life Baseline/Screening Version - Total number of interrupted Baseline/Screening
Interrupted Suicide
Attempts (Lifetime)
page 249 of 1925

C106661 CSS04TC
Code Value
C106743 CSS0416B CSS04-Number of Columbia-Suicide Severity Rating Scale C-SSRS

Interrupt Attempts-P_Y Baseline/Screening Version - Total number of interrupted Baseline/Screening
Interrupted Suicide
Attempts (Past X Years)
C106744 CSS0416C CSS04-Interrupted Columbia-Suicide Severity Rating Scale C-SSRS

Attempt, Describe Baseline/Screening Version - Description of interrupted Baseline/Screening
Interrupted Suicide
Attempt
C106745 CSS0417A CSS04-Aborted Attempt- Columbia-Suicide Severity Rating Scale C-SSRS

Life Baseline/Screening Version - Has there been a time when Baseline/Screening
you started to do something to try to end your life but Version - Aborted Suicide
you stopped yourself before you actually did anything? Attempt (Lifetime)
(Lifetime).
C106746 CSS0417B CSS04-Aborted Attempt- Columbia-Suicide Severity Rating Scale C-SSRS

P_Y Baseline/Screening Version - Has there been a time when Baseline/Screening
you stopped yourself before you actually did anything? Attempt (Past X Years)
(Past _ Years).

Aborted Attempts-Life Baseline/Screening Version - Total number of aborted Baseline/Screening
Aborted Suicide Attempts
(Lifetime)

Aborted Attempts-P_Y Baseline/Screening Version - Total number of aborted Baseline/Screening
(Past X Years)
C106749 CSS0418C CSS04-Aborted Attempt, Columbia-Suicide Severity Rating Scale C-SSRS

Describe Baseline/Screening Version - Description of aborted Baseline/Screening
Aborted Suicide Attempt

Acts/Behavior-Life Baseline/Screening Version - Have you taken any steps Baseline/Screening
towards making a suicide attempt or preparing to kill Version - Preparatory
yourself (such as collecting pills, getting a gun, giving Acts or Behaviors Toward
valuables away or writing a suicide note)? (Lifetime). Suicide Attempt
(Lifetime)
C106751 CSS0419B CSS04-Preparatory Columbia-Suicide Severity Rating Scale C-SSRS

Acts/Behavior-P_Y Baseline/Screening Version - Have you taken any steps Baseline/Screening
valuables away or writing a suicide note)? (Past _ Years). Suicide Attempt (Past X
Years)
C106752 CSS0419C CSS04-Preparatory Columbia-Suicide Severity Rating Scale C-SSRS

Acts/Behav, Descr Baseline/Screening Version - Description of preparatory Baseline/Screening
acts or behavior. Version - Description of
Preparatory Acts or
Behaviors Toward Suicide
Attempt
C106753 CSS0420A CSS04-Suicidal Behavior- Columbia-Suicide Severity Rating Scale C-SSRS

Life Baseline/Screening Version - Suicidal behavior was Baseline/Screening
present during the assessment period? (Lifetime). Version - Suicidal
Behavior (Lifetime)
C106754 CSS0420B CSS04-Suicidal Behavior- Columbia-Suicide Severity Rating Scale C-SSRS

P_Y Baseline/Screening Version - Suicidal behavior was Baseline/Screening
present during the assessment period? (Past _ Years). Version - Suicidal
Behavior (Past X Years)

Attempt Date Baseline/Screening Version - Most recent attempt date. Baseline/Screening
Version - Most Recent
Suicide Attempt Date

Attempt Damage Baseline/Screening Version - Most recent attempt actual Baseline/Screening
lethality/medical damage. Version - Most Recent
Suicide Attempt Actual
page 250 of 1925

C106661 CSS04TC
Code Value

Attempt Potential Baseline/Screening Version - Most recent attempt Baseline/Screening
potential lethality. Version - Most Recent
Suicide Attempt Potential
Lethality

Attempt Date Baseline/Screening Version - Most lethal attempt date. Baseline/Screening
Version - Most Lethal

Attempt Damage Baseline/Screening Version - Most lethal attempt actual Baseline/Screening
lethality/medical damage. Version - Most Lethal

Attempt Potential Baseline/Screening Version - Most lethal attempt Baseline/Screening
potential lethality. Version - Most Lethal
Lethality
Baseline/Screening Version - Initial/first attempt date. Baseline/Screening
Version - First Suicide
Attempt Date

Damage Baseline/Screening Version - Initial/first attempt actual Baseline/Screening
lethality/medical damage. Version - First Suicide
Attempt Actual

Potential Baseline/Screening Version - Initial/first attempt potential Baseline/Screening
lethality. Version - First Suicide
Attempt Potential
Lethality
page 251 of 1925

CSS04TN (Columbia-Suicide Severity Rating Scale Baseline/Screening Version Questionnaire Test
Name)
C106660 CSS04TN
Code Value
Describe Describe Baseline/Screening Version - Description of aborted Baseline/Screening
C106745 CSS04-Aborted Attempt- CSS04-Aborted Attempt- Columbia-Suicide Severity Rating Scale C-SSRS
Life Life Baseline/Screening Version - Has there been a time when Baseline/Screening
you stopped yourself before you actually did anything? Attempt (Lifetime)
(Lifetime).
P_Y P_Y Baseline/Screening Version - Has there been a time when Baseline/Screening
you stopped yourself before you actually did anything? Attempt (Past X Years)
(Past _ Years).
Describe Describe Baseline/Screening Version - Description of actual Baseline/Screening
C106733 CSS04-Actual Attempt- CSS04-Actual Attempt- Columbia-Suicide Severity Rating Scale C-SSRS
Life Life Baseline/Screening Version - Have you made a suicide Baseline/Screening
you done anything dangerous where you could have Attempt (Lifetime)
died? (Lifetime).
P_Y P_Y Baseline/Screening Version - Have you made a suicide Baseline/Screening
you done anything dangerous where you could have Attempt (Past X Years)
died? (Past _ Years).
Damage Damage Baseline/Screening Version - Initial/first attempt actual Baseline/Screening
lethality/medical damage. Version - First Suicide
Attempt Actual
Baseline/Screening Version - Initial/first attempt date. Baseline/Screening
Version - First Suicide
Attempt Date
Potential Potential Baseline/Screening Version - Initial/first attempt potential Baseline/Screening
lethality. Version - First Suicide
Attempt Potential
Lethality
Plan, Describe Plan, Describe Baseline/Screening Version - Description of active suicidal Baseline/Screening
ideation with some intent to act, without specific plan. Version - Description of
Plan-Life Plan-Life Baseline/Screening Version - Have you had these Baseline/Screening
(Lifetime). Ideation with Some
Plan-P_M Plan-P_M Baseline/Screening Version - Have you had these Baseline/Screening
(Past _ Months). Ideation with Some
Specific Plan (Past X
Months)
page 252 of 1925

C106660 CSS04TN
Code Value
No Plan, Describe No Plan, Describe Baseline/Screening Version - Description of active suicidal Baseline/Screening
ideation with any methods (not plan) without intent to Version - Description of
act. Active Suicidal Ideation
Act
No Plan-Life No Plan-Life Baseline/Screening Version - Have you been thinking Baseline/Screening
about how you might do this? (Lifetime). Version - Active Suicidal
Ideation with Any
Methods (Not Plan)
(Lifetime)
No Plan-P_M No Plan-P_M Baseline/Screening Version - Have you been thinking Baseline/Screening
about how you might do this? (Past _ Months). Version - Active Suicidal
Ideation with Any
Methods (Not Plan)
(Past X Months)
Describe Describe Baseline/Screening Version - Description of active suicidal Baseline/Screening
ideation with specific plan and intent. Version - Description of
Intent
Life Life Baseline/Screening Version - Have you started to work Baseline/Screening
you intend to carry out this plan? (Lifetime). Ideation with Specific
Plan and Intent (Lifetime)
P_M P_M Baseline/Screening Version - Have you started to work Baseline/Screening
you intend to carry out this plan? (Past _ Months). Ideation with Specific
Plan and Intent (Past X
Months)

Attempt, Describe Attempt, Describe Baseline/Screening Version - Description of interrupted Baseline/Screening
Interrupted Suicide
Attempt

Attempt-Life Attempt-Life Baseline/Screening Version - Has there been a time when Baseline/Screening
someone or something stopped you before you actually Suicide Attempt
did anything? (Lifetime). (Lifetime)

Attempt-P_Y Attempt-P_Y Baseline/Screening Version - Has there been a time when Baseline/Screening
someone or something stopped you before you actually Suicide Attempt (Past X
did anything? (Past _ Years). Years)
Attempt Damage Attempt Damage Baseline/Screening Version - Most lethal attempt actual Baseline/Screening
lethality/medical damage. Version - Most Lethal
Attempt Date Attempt Date Baseline/Screening Version - Most lethal attempt date. Baseline/Screening
Version - Most Lethal
Attempt Potential Attempt Potential Baseline/Screening Version - Most lethal attempt Baseline/Screening
potential lethality. Version - Most Lethal
Lethality
Attempt Damage Attempt Damage Baseline/Screening Version - Most recent attempt actual Baseline/Screening
lethality/medical damage. Version - Most Recent
page 253 of 1925

C106660 CSS04TN
Code Value
Attempt Date Attempt Date Baseline/Screening Version - Most recent attempt date. Baseline/Screening
Version - Most Recent
Attempt Potential Attempt Potential Baseline/Screening Version - Most recent attempt Baseline/Screening
potential lethality. Version - Most Recent
Lethality
Control-Life Control-Life Baseline/Screening Version - Could/can you stop thinking Baseline/Screening
(Lifetime)
Control-P_M Control-P_M Baseline/Screening Version - Could/can you stop thinking Baseline/Screening
(Past _ Months). Most Severe Ideation
(Past X Months)
Desc-Life Desc-Life Baseline/Screening Version - Description of most severe Baseline/Screening
ideation. (Lifetime). Version - Describe Most
Severe Ideation
(Lifetime)
Desc-P_M Desc-P_M Baseline/Screening Version - Description of most severe Baseline/Screening
ideation. (Past _ Months). Version - Describe Most
Severe Ideation (Past X
Months)
Deterrents-Life Deterrents-Life Baseline/Screening Version - Are there things-anyone or Baseline/Screening
committing suicide? (Lifetime). (Lifetime)
Deterrents-P_M Deterrents-P_M Baseline/Screening Version - Are there things-anyone or Baseline/Screening
committing suicide? (Past _ Months). (Past X Months)
Duration-Life Duration-Life Baseline/Screening Version - When you have the Baseline/Screening
thoughts how long do they last? (Lifetime). Version - Duration of
(Lifetime)
Duration-P_M Duration-P_M Baseline/Screening Version - When you have the Baseline/Screening
thoughts how long do they last? (Past _ Months). Version - Duration of
(Past X Months)
Frequency-Life Frequency-Life Baseline/Screening Version - How many times have you Baseline/Screening
had these thoughts? (Lifetime). Version - Frequency of
(Lifetime)
Frequency-P_M Frequency-P_M Baseline/Screening Version - How many times have you Baseline/Screening
had these thoughts? (Past _ Months). Version - Frequency of
(Past X Months)
Reasons-Life Reasons-Life Baseline/Screening Version - What sort of reasons did Baseline/Screening
feeling (in other words you couldn't go on living with this (Lifetime)
revenge or a reaction from others? Or both? (Lifetime).
page 254 of 1925

C106660 CSS04TN
Code Value
Reasons-P_M Reasons-P_M Baseline/Screening Version - What sort of reasons did Baseline/Screening
feeling (in other words you couldn't go on living with this (Past X Months)
revenge or a reaction from others? Or both? (Past _
Months).
Life Life Baseline/Screening Version - Most severe ideation. Baseline/Screening
(Lifetime). Version - Most Severe
Ideation (Lifetime)
P_M P_M Baseline/Screening Version - Most severe ideation. (Past Baseline/Screening
_ Months). Version - Most Severe
Ideation (Past X Months)
Thought, Describe Thought, Describe Baseline/Screening Version - Description of non-specific Baseline/Screening
active suicidal thoughts. Version - Description of
Non-Specific Active
Suicidal Thoughts
Thought-Life Thought-Life Baseline/Screening Version - Have you actually had any Baseline/Screening
thoughts of killing yourself? (Lifetime). Version - Non-Specific
(Lifetime)
Thought-P_M Thought-P_M Baseline/Screening Version - Have you actually had any Baseline/Screening
thoughts of killing yourself? (Past _ Months). Version - Non-Specific
(Past X Months)
injur Behav-Life injur Behav-Life Baseline/Screening Version - Has the subject engaged in Baseline/Screening
non-suicidal self-injurious behavior. (Lifetime). Version - Non-suicidal
(Lifetime)
injur Behav-P_Y injur Behav-P_Y Baseline/Screening Version - Has the subject engaged in Baseline/Screening
non-suicidal self-injurious behavior. (Past _ Years). Version - Non-suicidal
(Past X Years)

Aborted Attempts-Life Aborted Attempts-Life Baseline/Screening Version - Total number of aborted Baseline/Screening
(Lifetime)

Aborted Attempts-P_Y Aborted Attempts-P_Y Baseline/Screening Version - Total number of aborted Baseline/Screening
(Past X Years)
Attempts-Life Attempts-Life Baseline/Screening Version - Total number of actual Baseline/Screening
(Lifetime)
Attempts-P_Y Attempts-P_Y Baseline/Screening Version - Total number of actual Baseline/Screening
(Past X Years)

Interrupt Attempts-Life Interrupt Attempts-Life Baseline/Screening Version - Total number of interrupted Baseline/Screening
Interrupted Suicide
Attempts (Lifetime)

Interrupt Attempts-P_Y Interrupt Attempts-P_Y Baseline/Screening Version - Total number of interrupted Baseline/Screening
Interrupted Suicide
Attempts (Past X Years)
page 255 of 1925

C106660 CSS04TN
Code Value

Acts/Behav, Descr Acts/Behav, Descr Baseline/Screening Version - Description of preparatory Baseline/Screening
acts or behavior. Version - Description of
Preparatory Acts or
Attempt

Acts/Behavior-Life Acts/Behavior-Life Baseline/Screening Version - Have you taken any steps Baseline/Screening
valuables away or writing a suicide note)? (Lifetime). Suicide Attempt
(Lifetime)

Acts/Behavior-P_Y Acts/Behavior-P_Y Baseline/Screening Version - Have you taken any steps Baseline/Screening
valuables away or writing a suicide note)? (Past _ Years). Suicide Attempt (Past X
Years)
C106753 CSS04-Suicidal Behavior- CSS04-Suicidal Behavior- Columbia-Suicide Severity Rating Scale C-SSRS
Life Life Baseline/Screening Version - Suicidal behavior was Baseline/Screening
present during the assessment period? (Lifetime). Version - Suicidal
Behavior (Lifetime)
P_Y P_Y Baseline/Screening Version - Suicidal behavior was Baseline/Screening
present during the assessment period? (Past _ Years). Version - Suicidal
Behavior (Past X Years)
Describe Describe Baseline/Screening Version - Description of wishing to be Baseline/Screening
dead. Version - Description of
Wish to be Dead
Life Life Baseline/Screening Version - Have you wished you were Baseline/Screening
(Lifetime). (Lifetime)
P_M P_M Baseline/Screening Version - Have you wished you were Baseline/Screening
(Past _ Months). (Past X Months)
page 256 of 1925

CSS05TC (Columbia-Suicide Severity Rating Scale Already Enrolled Subjects Questionnaire Test Code)
C106659 CSS05TC
Code Value
C107027 CSS0501A CSS05-Wish to be Dead- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Subjects - Have you wished you were dead or wished you Subjects - Wish to Be
could go to sleep and not wake up? (Prior to Study Dead (Prior to Study
Entry). Entry)
C107028 CSS0501B CSS05-Wish to be Dead- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Subjects - Have you wished you were dead or wished you Subjects - Wish to Be
could go to sleep and not wake up? (Since Study Start). Dead (Since Study Start)
C107029 CSS0501C CSS05-Wish to be Dead, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Describe Subjects - Description of wishing to be dead. Subjects - Description of
Wish to Be Dead
C107030 CSS0502A CSS05-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Thought-Prior Subjects - Have you actually had any thoughts of killing Subjects - Non-Specific
yourself? (Prior to Study Entry). Active Suicidal Thoughts
(Prior to Study Entry)
C107031 CSS0502B CSS05-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Thought-Since Subjects - Have you actually had any thoughts of killing Subjects - Non-Specific
yourself? (Since Study Start). Active Suicidal Thoughts
(Since Study Start)
C107032 CSS0502C CSS05-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Thought, Describe Subjects - Description of non-specific active suicidal Subjects - Description of
thoughts. Non-Specific Active
Suicidal Thoughts
C107033 CSS0503A CSS05-Idea, No Intent, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
No Plan-Prior Subjects - Have you been thinking about how you might Subjects - Active Suicidal
do this? (Prior to Study Entry). Ideation With Any
Methods (Not Plan)
Without Intent to Act
C107034 CSS0503B CSS05-Idea, No Intent, Columbia-Suicide Suicide Rating Scale Already Enrolled C-SSRS Already Enrolled
No Plan-Since Subjects - Have you been thinking about how you might Subjects - Active Suicidal
do this? (Since Study Start). Ideation With Any
Methods (Not Plan)
(Since Study Start)
C107035 CSS0503C CSS05-Idea, No Intent, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
No Plan, Describe Subjects - Description of active suicidal ideation with any Subjects - Description of
methods (not plan) without intent to act. Active Suicidal Ideation
With Any Methods (Not
Plan) Without Intent to
Act
C107036 CSS0504A CSS05-Idea, Intent, No Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Plan-Prior Subjects - Have you had these thoughts and had some Subjects - Active Suicidal
intention of acting on them? (Prior to Study Entry). Ideation With Some
Intent to Act, Without
Specific Plan (Prior to
Study Entry)
C107037 CSS0504B CSS05-Idea, Intent, No Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Plan-Since Subjects - Have you had these thoughts and had some Subjects - Active Suicidal
intention of acting on them? (Since Study Start). Ideation With Some
Specific Plan (Since Study
Start)
C107038 CSS0504C CSS05-Idea, Intent, No Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Plan, Describe Subjects - Description of active suicidal ideation with Subjects - Description of
some intent to act, without specific plan. Active Suicidal Ideation
With Some Intent to Act,
Without Specific Plan
C107039 CSS0505A CSS05-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Subjects - Have you started to work out or worked out Subjects - Active Suicidal
the details of how to kill yourself? Do you intend to carry Ideation With Specific
out this plan? (Prior to Study Entry). Plan and Intent (Prior to
Study Entry)
C107040 CSS0505B CSS05-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Subjects - Have you started to work out or worked out Subjects - Active Suicidal
out this plan? (Since Study Start). Plan and Intent (Since
Study Start)
page 257 of 1925

C106659 CSS05TC
Code Value
C107041 CSS0505C CSS05-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Describe Subjects - Description of active suicidal ideation with Subjects - Description of
specific plan and intent. Active Suicidal Ideation
With Specific Plan and
Intent
C107042 CSS0506A CSS05-Most Severe Idea- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Subjects - Most severe ideation. (Prior to Study Entry). Subjects - Most Severe
Ideation (Prior to Study
Entry)
C107043 CSS0506B CSS05-Most Severe Idea, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Desc-Prior Subjects - Description of most severe ideation. (Prior to Subjects - Describe Most
Study Entry). Severe Ideation (Prior to
Study Entry)
C107044 CSS0506C CSS05-Most Severe Idea- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Subjects - Most severe ideation. (Since Study Start). Subjects - Most Severe
Ideation (Since Study
Start)
C107045 CSS0506D CSS05-Most Severe Idea, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Desc-Since Subjects - Description of most severe ideation. (Since Subjects - Describe Most
Study Start). Severe Ideation (Since
Study Start)
C107046 CSS0507A CSS05-Most Severe Idea, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Frequency-Prior Subjects - How many times have you had these Subjects - Frequency of
thoughts? (Prior to Study Entry). Most Severe Ideation
Frequency-Since Subjects - How many times have you had these Subjects - Frequency of
thoughts? (Since Study Start). Most Severe Ideation
(Since Study Start)
Duration-Prior Subjects - When you have the thoughts how long do they Subjects - Duration of
last? (Prior to Study Entry). Most Severe Ideation
Duration-Since Subjects - When you have the thoughts how long do they Subjects - Duration of
last? (Since Study Start). Most Severe Ideation
(Since Study Start)
Control-Prior Subjects - Could/can you stop thinking about killing Subjects - Controllability
yourself or wanting to die if you want to? (Prior to Study of Most Severe Ideation
Entry). (Prior to Study Entry)
Control-Since Subjects - Could/can you stop thinking about killing Subjects - Controllability
yourself or wanting to die if you want to? (Since Study of Most Severe Ideation
Start). (Since Study Start)
Deterrents-Prior Subjects - Are there things-anyone or anything (e.g., Subjects - Deterrents to
family, religion, pain of death) - that stopped you from Most Severe Ideation
wanting to die or acting on thoughts of committing (Prior to Study Entry)
suicide? (Prior to Study Entry).
Deterrents-Since Subjects - Are there things-anyone or anything (e.g., Subjects - Deterrents to
wanting to die or acting on thoughts of committing (Since Study Start)
suicide? (Since Study Start).
Reasons-Prior Subjects - What sort of reasons did you have for thinking Subjects - Reasons For
about wanting to die or killing yourself? Was it to end the Most Severe Ideation
pain or stop the way you were feeling (in other words you (Prior to Study Entry)
from others? Or both? (Prior to Study Entry).
Reasons-Since Subjects - What sort of reasons did you have for thinking Subjects - Reasons For
pain or stop the way you were feeling (in other words you (Since Study Start)
from others? Or both? (Since Study Start).
page 258 of 1925

C106659 CSS05TC
Code Value
C107056 CSS0512A CSS05-Actual Attempt- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Subjects - Have you made a suicide attempt? Have you Subjects - Actual Suicide
done anything to harm yourself? Have you done anything Attempt (Prior to Study
dangerous where you could have died? (Prior to Study Entry)
Entry).
C107057 CSS0512B CSS05-Actual Attempt- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Subjects - Have you made a suicide attempt? Have you Subjects - Actual Suicide
done anything to harm yourself? Have you done anything Attempt (Since Study
dangerous where you could have died? (Since Study Start)
Start).
C107058 CSS0513A CSS05-Number of Actual Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempts-Prior Subjects - Total number of actual attempts. (Prior to Subjects - Number of
Study Entry). Actual Suicide Attempts
C107059 CSS0513B CSS05-Number of Actual Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempts-Since Subjects - Total number of actual attempts. (Since Study Subjects - Number of
Start). Actual Suicide Attempts
(Since Study Start)
C107060 CSS0513C CSS05-Actual Attempt, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Describe Subjects - Description of actual attempt. Subjects - Description of
C107061 CSS0514A CSS05-Non-suicid Self- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
injur Behav-Prior Subjects - Has the subject engaged in non-suicidal self- Subjects - Non-suicidal
injurious behavior? (Prior to Study Entry). Self-injurious Behavior
C107062 CSS0514B CSS05-Non-suicid Self- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
injur Behav-Since Subjects - Has the subject engaged in non-suicidal self- Subjects - Non-suicidal
injurious behavior? (Since Study Start). Self-injurious Behavior
(Since Study Start)
C107063 CSS0515A CSS05-Interrupted Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt-Prior Subjects - Has there been a time when you started to do Subjects - Interrupted
something to try to end your life but someone or Suicide Attempt (Prior to
something stopped you before you actually did anything? Study Entry)
(Prior to Study Entry).
C107064 CSS0515B CSS05-Interrupted Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt-Since Subjects - Has there been a time when you started to do Subjects - Interrupted
something to try to end your life but someone or Suicide Attempt (Since
something stopped you before you actually did anything? Study Start)
(Since Study Start).
C107065 CSS0516A CSS05-Num of Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Interrupted Attempts- Subjects - Total number of interrupted attempts. (Prior to Subjects - Number of
Prior Study Entry). Interrupted Suicide
Attempts (Prior to Study
Entry)
C107066 CSS0516B CSS05-Num of Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Interrupted Attempts- Subjects - Total number of interrupted attempts. (Since Subjects - Number of
Since Study Start). Interrupted Suicide
Attempts (Since Study
Start)
C107067 CSS0516C CSS05-Interrupted Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt, Describe Subjects - Description of interrupted attempt. Subjects - Description of
Interrupted Suicide
Attempt
C107068 CSS0517A CSS05-Aborted Attempt- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Subjects - Has there been a time when you started to do Subjects - Aborted
something to try to end your life but you stopped yourself Suicide Attempt (Prior to
before you actually did anything? (Prior to Study Entry). Study Entry)
C107069 CSS0517B CSS05-Aborted Attempt- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Subjects - Has there been a time when you started to do Subjects - Aborted
something to try to end your life but you stopped yourself Suicide Attempt (Since
before you actually did anything? (Since Study Start). Study Start)
C107070 CSS0518A CSS05-Number of Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Aborted Attempts-Prior Subjects - Total number of aborted attempts. (Prior to Subjects - Number of
Study Entry). Aborted Suicide Attempts
C107071 CSS0518B CSS05-Number of Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Aborted Attempts-Since Subjects - Total number of aborted attempts. (Since Subjects - Number of
Study Start). Aborted Suicide Attempts
(Since Study Start)
page 259 of 1925

C106659 CSS05TC
Code Value
C107072 CSS0518C CSS05-Aborted Attempt, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Describe Subjects - Description of aborted attempt. Subjects - Description of
C107073 CSS0519A CSS05-Preparatory Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Acts/Behavior-Prior Subjects - Have you taken any steps towards making a Subjects - Preparatory
suicide attempt or preparing to kill yourself (such as Acts or Behaviors Toward
collecting pills, getting a gun, giving valuables away or Suicide Attempt (Prior to
writing a suicide note)? (Prior to Study Entry). Study Entry)
C107074 CSS0519B CSS05-Preparatory Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Acts/Behavior-Since Subjects - Have you taken any steps towards making a Subjects - Preparatory
collecting pills, getting a gun, giving valuables away or Suicide Attempt (Since
writing a suicide note)? (Since Study Start). Study Start)
C107075 CSS0519C CSS05-Preparatory Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Acts/Behavior, Descr Subjects - Description of preparatory acts or behavior. Subjects - Description of
Preparatory Acts or
Attempt
C107076 CSS0520A CSS05-Suicidal Behavior- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Subjects - Suicidal behavior was present during the Subjects - Suicidal
assessment period? (Prior to Study Entry). Behavior (Prior to Study
Entry)
C107077 CSS0520B CSS05-Suicidal Behavior- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Subjects - Suicidal behavior was present during the Subjects - Suicidal
assessment period? (Since Study Start). Behavior (Since Study
Start)
C107078 CSS0521A CSS05-Completed Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Suicide-Prior Subjects - Completed suicide? (Prior to Study Entry). Subjects - Completed
Suicide (Prior to Study
Entry)
C107079 CSS0521B CSS05-Completed Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Suicide-Since Subjects - Completed suicide? (Since Study Start). Subjects - Completed
Suicide (Since Study
Start)
C107080 CSS0522A CSS05-Most Recent Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt Date Subjects - Most recent attempt date. Subjects - Most Recent
C107081 CSS0522B CSS05-Most Recent Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt Damage Subjects - Most recent attempt actual lethality/medical Subjects - Most Recent
damage. Suicide Attempt Actual
C107082 CSS0522C CSS05-Most Recent Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt Potential Subjects - Most recent attempt potential lethality. Subjects - Most Recent
Lethality
C107083 CSS0523A CSS05-Most Lethal Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt Date Subjects - Most lethal attempt date. Subjects - Most Lethal
C107084 CSS0523B CSS05-Most Lethal Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt Damage Subjects - Most lethal attempt actual lethality/medical Subjects - Most Lethal
C107085 CSS0523C CSS05-Most Lethal Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt Potential Subjects - Most lethal attempt potential lethality. Subjects - Most Lethal
Lethality
C107086 CSS0524A CSS05-First Attempt Date Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Subjects - Initial/first attempt date. Subjects - First Suicide
Attempt Date
C107087 CSS0524B CSS05-First Attempt Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Damage Subjects - Initial/first attempt actual lethality/medical Subjects - First Suicide
damage. Attempt Actual
C107088 CSS0524C CSS05-First Attempt Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Potential Subjects - Initial/first attempt potential lethality. Subjects - First Suicide
Attempt Potential
Lethality
page 260 of 1925

CSS05TN (Columbia-Suicide Severity Rating Scale Already Enrolled Subjects Questionnaire Test Name)
C106658 CSS05TN
Code Value
C107072 CSS05-Aborted Attempt, CSS05-Aborted Attempt, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Describe Describe Subjects - Description of aborted attempt. Subjects - Description of
C107068 CSS05-Aborted Attempt- CSS05-Aborted Attempt- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Prior Subjects - Has there been a time when you started to do Subjects - Aborted
something to try to end your life but you stopped yourself Suicide Attempt (Prior to
before you actually did anything? (Prior to Study Entry). Study Entry)
C107069 CSS05-Aborted Attempt- CSS05-Aborted Attempt- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Since Subjects - Has there been a time when you started to do Subjects - Aborted
something to try to end your life but you stopped yourself Suicide Attempt (Since
before you actually did anything? (Since Study Start). Study Start)
C107060 CSS05-Actual Attempt, CSS05-Actual Attempt, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Describe Describe Subjects - Description of actual attempt. Subjects - Description of
C107056 CSS05-Actual Attempt- CSS05-Actual Attempt- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Prior Subjects - Have you made a suicide attempt? Have you Subjects - Actual Suicide
done anything to harm yourself? Have you done anything Attempt (Prior to Study
dangerous where you could have died? (Prior to Study Entry)
Entry).
C107057 CSS05-Actual Attempt- CSS05-Actual Attempt- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Since Subjects - Have you made a suicide attempt? Have you Subjects - Actual Suicide
done anything to harm yourself? Have you done anything Attempt (Since Study
dangerous where you could have died? (Since Study Start)
Start).
C107078 CSS05-Completed CSS05-Completed Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Suicide-Prior Suicide-Prior Subjects - Completed suicide? (Prior to Study Entry). Subjects - Completed
Suicide (Prior to Study
Entry)
C107079 CSS05-Completed CSS05-Completed Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Suicide-Since Suicide-Since Subjects - Completed suicide? (Since Study Start). Subjects - Completed
Suicide (Since Study
Start)
C107087 CSS05-First Attempt CSS05-First Attempt Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Damage Damage Subjects - Initial/first attempt actual lethality/medical Subjects - First Suicide
C107086 CSS05-First Attempt Date CSS05-First Attempt Date Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Subjects - Initial/first attempt date. Subjects - First Suicide
Attempt Date
C107088 CSS05-First Attempt CSS05-First Attempt Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Potential Potential Subjects - Initial/first attempt potential lethality. Subjects - First Suicide
Attempt Potential
Lethality
C107038 CSS05-Idea, Intent, No CSS05-Idea, Intent, No Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Plan, Describe Plan, Describe Subjects - Description of active suicidal ideation with Subjects - Description of
With Some Intent to Act,
Plan-Prior Plan-Prior Subjects - Have you had these thoughts and had some Subjects - Active Suicidal
intention of acting on them? (Prior to Study Entry). Ideation With Some
Specific Plan (Prior to
Study Entry)
Plan-Since Plan-Since Subjects - Have you had these thoughts and had some Subjects - Active Suicidal
intention of acting on them? (Since Study Start). Ideation With Some
Specific Plan (Since Study
Start)
C107035 CSS05-Idea, No Intent, CSS05-Idea, No Intent, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
No Plan, Describe No Plan, Describe Subjects - Description of active suicidal ideation with any Subjects - Description of
With Any Methods (Not
Act
page 261 of 1925

C106658 CSS05TN
Code Value
C107033 CSS05-Idea, No Intent, CSS05-Idea, No Intent, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
No Plan-Prior No Plan-Prior Subjects - Have you been thinking about how you might Subjects - Active Suicidal
do this? (Prior to Study Entry). Ideation With Any
Methods (Not Plan)
C107034 CSS05-Idea, No Intent, CSS05-Idea, No Intent, Columbia-Suicide Suicide Rating Scale Already Enrolled C-SSRS Already Enrolled
No Plan-Since No Plan-Since Subjects - Have you been thinking about how you might Subjects - Active Suicidal
do this? (Since Study Start). Ideation With Any
Methods (Not Plan)
(Since Study Start)
C107041 CSS05-Idea, Plan, Intent, CSS05-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Describe Describe Subjects - Description of active suicidal ideation with Subjects - Description of
With Specific Plan and
Intent
C107039 CSS05-Idea, Plan, Intent- CSS05-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Prior Subjects - Have you started to work out or worked out Subjects - Active Suicidal
out this plan? (Prior to Study Entry). Plan and Intent (Prior to
Study Entry)
C107040 CSS05-Idea, Plan, Intent- CSS05-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Since Subjects - Have you started to work out or worked out Subjects - Active Suicidal
out this plan? (Since Study Start). Plan and Intent (Since
Study Start)
C107067 CSS05-Interrupted CSS05-Interrupted Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt, Describe Attempt, Describe Subjects - Description of interrupted attempt. Subjects - Description of
Interrupted Suicide
Attempt
Attempt-Prior Attempt-Prior Subjects - Has there been a time when you started to do Subjects - Interrupted
something to try to end your life but someone or Suicide Attempt (Prior to
something stopped you before you actually did anything? Study Entry)
(Prior to Study Entry).
Attempt-Since Attempt-Since Subjects - Has there been a time when you started to do Subjects - Interrupted
something to try to end your life but someone or Suicide Attempt (Since
something stopped you before you actually did anything? Study Start)
(Since Study Start).
C107084 CSS05-Most Lethal CSS05-Most Lethal Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt Damage Attempt Damage Subjects - Most lethal attempt actual lethality/medical Subjects - Most Lethal
Attempt Date Attempt Date Subjects - Most lethal attempt date. Subjects - Most Lethal
Attempt Potential Attempt Potential Subjects - Most lethal attempt potential lethality. Subjects - Most Lethal
Lethality
C107081 CSS05-Most Recent CSS05-Most Recent Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempt Damage Attempt Damage Subjects - Most recent attempt actual lethality/medical Subjects - Most Recent
Attempt Date Attempt Date Subjects - Most recent attempt date. Subjects - Most Recent
Attempt Potential Attempt Potential Subjects - Most recent attempt potential lethality. Subjects - Most Recent
Lethality
C107050 CSS05-Most Severe Idea, CSS05-Most Severe Idea, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Control-Prior Control-Prior Subjects - Could/can you stop thinking about killing Subjects - Controllability
yourself or wanting to die if you want to? (Prior to Study of Most Severe Ideation
Entry). (Prior to Study Entry)
page 262 of 1925

C106658 CSS05TN
Code Value
Control-Since Control-Since Subjects - Could/can you stop thinking about killing Subjects - Controllability
yourself or wanting to die if you want to? (Since Study of Most Severe Ideation
Start). (Since Study Start)
Desc-Prior Desc-Prior Subjects - Description of most severe ideation. (Prior to Subjects - Describe Most
Study Entry). Severe Ideation (Prior to
Study Entry)
Desc-Since Desc-Since Subjects - Description of most severe ideation. (Since Subjects - Describe Most
Study Start). Severe Ideation (Since
Study Start)
Deterrents-Prior Deterrents-Prior Subjects - Are there things-anyone or anything (e.g., Subjects - Deterrents to
wanting to die or acting on thoughts of committing (Prior to Study Entry)
suicide? (Prior to Study Entry).
Deterrents-Since Deterrents-Since Subjects - Are there things-anyone or anything (e.g., Subjects - Deterrents to
wanting to die or acting on thoughts of committing (Since Study Start)
suicide? (Since Study Start).
Duration-Prior Duration-Prior Subjects - When you have the thoughts how long do they Subjects - Duration of
last? (Prior to Study Entry). Most Severe Ideation
Duration-Since Duration-Since Subjects - When you have the thoughts how long do they Subjects - Duration of
last? (Since Study Start). Most Severe Ideation
(Since Study Start)
Frequency-Prior Frequency-Prior Subjects - How many times have you had these Subjects - Frequency of
thoughts? (Prior to Study Entry). Most Severe Ideation
Frequency-Since Frequency-Since Subjects - How many times have you had these Subjects - Frequency of
thoughts? (Since Study Start). Most Severe Ideation
(Since Study Start)
Reasons-Prior Reasons-Prior Subjects - What sort of reasons did you have for thinking Subjects - Reasons For
pain or stop the way you were feeling (in other words you (Prior to Study Entry)
from others? Or both? (Prior to Study Entry).
Reasons-Since Reasons-Since Subjects - What sort of reasons did you have for thinking Subjects - Reasons For
pain or stop the way you were feeling (in other words you (Since Study Start)
from others? Or both? (Since Study Start).
C107042 CSS05-Most Severe Idea- CSS05-Most Severe Idea- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Prior Subjects - Most severe ideation. (Prior to Study Entry). Subjects - Most Severe
Ideation (Prior to Study
Entry)
C107044 CSS05-Most Severe Idea- CSS05-Most Severe Idea- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Since Subjects - Most severe ideation. (Since Study Start). Subjects - Most Severe
Ideation (Since Study
Start)
C107032 CSS05-Non-Spec Suicid CSS05-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Thought, Describe Thought, Describe Subjects - Description of non-specific active suicidal Subjects - Description of
Suicidal Thoughts
Thought-Prior Thought-Prior Subjects - Have you actually had any thoughts of killing Subjects - Non-Specific
yourself? (Prior to Study Entry). Active Suicidal Thoughts
page 263 of 1925

C106658 CSS05TN
Code Value
Thought-Since Thought-Since Subjects - Have you actually had any thoughts of killing Subjects - Non-Specific
yourself? (Since Study Start). Active Suicidal Thoughts
(Since Study Start)
C107061 CSS05-Non-suicid Self- CSS05-Non-suicid Self- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
injur Behav-Prior injur Behav-Prior Subjects - Has the subject engaged in non-suicidal self- Subjects - Non-suicidal
injurious behavior? (Prior to Study Entry). Self-injurious Behavior
C107062 CSS05-Non-suicid Self- CSS05-Non-suicid Self- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
injur Behav-Since injur Behav-Since Subjects - Has the subject engaged in non-suicidal self- Subjects - Non-suicidal
injurious behavior? (Since Study Start). Self-injurious Behavior
(Since Study Start)
C107065 CSS05-Num of CSS05-Num of Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Interrupted Attempts- Interrupted Attempts- Subjects - Total number of interrupted attempts. (Prior to Subjects - Number of
Prior Prior Study Entry). Interrupted Suicide
Attempts (Prior to Study
Entry)
C107066 CSS05-Num of CSS05-Num of Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Interrupted Attempts- Interrupted Attempts- Subjects - Total number of interrupted attempts. (Since Subjects - Number of
Since Since Study Start). Interrupted Suicide
Attempts (Since Study
Start)
C107070 CSS05-Number of CSS05-Number of Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Aborted Attempts-Prior Aborted Attempts-Prior Subjects - Total number of aborted attempts. (Prior to Subjects - Number of
Study Entry). Aborted Suicide Attempts
C107071 CSS05-Number of CSS05-Number of Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Aborted Attempts-Since Aborted Attempts-Since Subjects - Total number of aborted attempts. (Since Subjects - Number of
Study Start). Aborted Suicide Attempts
(Since Study Start)
C107058 CSS05-Number of Actual CSS05-Number of Actual Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempts-Prior Attempts-Prior Subjects - Total number of actual attempts. (Prior to Subjects - Number of
Study Entry). Actual Suicide Attempts
C107059 CSS05-Number of Actual CSS05-Number of Actual Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Attempts-Since Attempts-Since Subjects - Total number of actual attempts. (Since Study Subjects - Number of
Start). Actual Suicide Attempts
(Since Study Start)
C107075 CSS05-Preparatory CSS05-Preparatory Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Acts/Behavior, Descr Acts/Behavior, Descr Subjects - Description of preparatory acts or behavior. Subjects - Description of
Preparatory Acts or
Attempt
Acts/Behavior-Prior Acts/Behavior-Prior Subjects - Have you taken any steps towards making a Subjects - Preparatory
collecting pills, getting a gun, giving valuables away or Suicide Attempt (Prior to
writing a suicide note)? (Prior to Study Entry). Study Entry)
Acts/Behavior-Since Acts/Behavior-Since Subjects - Have you taken any steps towards making a Subjects - Preparatory
collecting pills, getting a gun, giving valuables away or Suicide Attempt (Since
writing a suicide note)? (Since Study Start). Study Start)
C107076 CSS05-Suicidal Behavior- CSS05-Suicidal Behavior- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Prior Subjects - Suicidal behavior was present during the Subjects - Suicidal
assessment period? (Prior to Study Entry). Behavior (Prior to Study
Entry)
C107077 CSS05-Suicidal Behavior- CSS05-Suicidal Behavior- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Since Subjects - Suicidal behavior was present during the Subjects - Suicidal
assessment period? (Since Study Start). Behavior (Since Study
Start)
C107029 CSS05-Wish to be Dead, CSS05-Wish to be Dead, Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Describe Describe Subjects - Description of wishing to be dead. Subjects - Description of
Wish to Be Dead
C107027 CSS05-Wish to be Dead- CSS05-Wish to be Dead- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Prior Prior Subjects - Have you wished you were dead or wished you Subjects - Wish to Be
could go to sleep and not wake up? (Prior to Study Dead (Prior to Study
Entry). Entry)
page 264 of 1925

C106658 CSS05TN
Code Value
C107028 CSS05-Wish to be Dead- CSS05-Wish to be Dead- Columbia-Suicide Severity Rating Scale Already Enrolled C-SSRS Already Enrolled
Since Since Subjects - Have you wished you were dead or wished you Subjects - Wish to Be
could go to sleep and not wake up? (Since Study Start). Dead (Since Study Start)
page 265 of 1925

CSS06TC (Columbia-Suicide Severity Rating Scale Children's Baseline Questionnaire Test Code)
C111336 CSS06TC
Code Value
C111527 CSS0601 CSS06-Wish to be Dead Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Have you thought about being dead or what it Baseline - Wish to be
would be like to be dead? Have you wished you were Dead
dead or wished you could go to sleep and never wake up?
Do you ever wish you weren't alive anymore?
C111528 CSS0601A CSS06-Wish to be Dead, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Baseline - Description of wishing to be dead. Baseline - Description of
Wish to be Dead
C111529 CSS0602 CSS06-Non-Specific Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Suicidal Thought Baseline - Have you thought about doing something to Baseline - Non-Specific
make yourself not alive anymore? Have you had any Active Suicidal Thoughts
thoughts about killing yourself?
C111530 CSS0602A CSS06-Non-Specific Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Suicid Thought, Descr Baseline - Description of non-specific active suicidal Baseline - Description of
Suicidal Thoughts
C111531 CSS0603 CSS06-Idea, No Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
No Plan Baseline - Have you thought about how you would do Baseline - Active Suicidal
that or how you would make yourself not alive anymore Ideation with Any
(kill yourself)? What did you think about? Methods (Not Plan)
C111532 CSS0603A CSS06-Idea, No Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
No Plan, Describe Baseline - Description of active suicidal ideation with any Baseline - Description of
Act
C111533 CSS0604 CSS06-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Intent, No Plan Baseline - When you thought about making yourself not Baseline - Active Suicidal
alive anymore (or killing yourself), did you think that this Ideation with Some
was something you might actually do? This is different Intent to Act, without
from (as opposed to) having the thoughts but knowing Specific Plan
you wouldn't do anything about it.
C111534 CSS0604A CSS06-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Intent No Plan Descr Baseline - Description of active suicidal ideation with Baseline - Description of
C111535 CSS0605 CSS06-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Plan/Intent Baseline - Have you ever decided how or when you would Baseline - Active Suicidal
make yourself not alive anymore/kill yourself? Have you Ideation with Specific
ever planned out (worked out the details of) how you Plan and Intent
would do it? What was your plan? When you made this
plan (or worked out these details), was any part of you
thinking about actually doing it?
C111536 CSS0605A CSS06-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Plan/Intent, Descr Baseline - Description of active suicidal ideation with Baseline - Description of
Intent
C111537 CSS0606 CSS06-Most Severe Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Ideation Baseline - Most severe ideation. Baseline - Most Severe
Ideation
C111538 CSS0606A CSS06-Most Severe Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Ideation, Description Baseline - Description of most severe ideation. Baseline - Describe Most
Severe Ideation
C111539 CSS0607 CSS06-Most Severe Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Ideation, Frequency Baseline - How many times have you had these thoughts? Baseline - Frequency of
C111540 CSS0607A CSS06-Frequency, Write Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Response Baseline - Frequency, write response. Baseline - Frequency,
Write Response
page 266 of 1925

C111336 CSS06TC
Code Value
C111541 CSS0608 CSS06-Actual Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Did you ever do anything to try to kill yourself Baseline - Actual Suicide
or make yourself not alive anymore? What did you do? Attempt
Did you ever hurt yourself on purpose? Why did you do
that?
C111542 CSS0609 CSS06-Number of Actual Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempts Baseline - Total number of actual attempts. Baseline - Number of
C111543 CSS0609A CSS06-Actual Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Baseline - Description of actual attempt. Baseline - Description of
C111544 CSS0610 CSS06-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
injurious Behav Baseline - Has subject engaged in non-suicidal self- Baseline - Non-suicidal
injurious behavior? Self-injurious Behavior
C111545 CSS0611 CSS06-Self-injur Behav, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Intent Unknown Baseline - Has subject engaged in self-injurious behavior, Baseline - Self-injurious
intent unknown? Behavior, Intent Unknown
C111546 CSS0612 CSS06-Interrupted Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Baseline - Has there been a time when you started to do Baseline - Interrupted
something to make yourself not alive anymore (end your Suicide Attempt
life or kill yourself) but someone or something stopped
you before you actually did anything? What did you do?
C111547 CSS0613 CSS06-Number of Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Interrupt Attempts Baseline - Total number of interrupted attempts. Baseline - Number of
Interrupted Suicide
Attempts
C111548 CSS0613A CSS06-Interrupted Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt, Describe Baseline - Description of interrupted attempt. Baseline - Description of
Interrupted Suicide
Attempt
C111549 CSS0614 CSS06-Aborted Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Has there been a time when you started to do Baseline - Aborted
life or kill yourself) but you changed your mind (stopped
yourself) before you actually did anything? What did you
do?
Aborted Attempts Baseline - Total number of aborted attempts. Baseline - Number of
C111551 CSS0615A CSS06-Aborted Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Baseline - Description of aborted attempt. Baseline - Description of
C111552 CSS0616 CSS06-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Acts/Behavior Baseline - Have you done anything to get ready to make Baseline - Preparatory
yourself not alive anymore (to end your life or kill Acts or Behaviors Toward
yourself) - like giving things away, writing a goodbye Suicide Attempt
note, getting things you need to kill yourself?
C111553 CSS0616A CSS06-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Acts/Behavior, Descr Baseline - Description of preparatory acts or behavior. Baseline - Description of
Preparatory Acts or
Attempt
C111554 CSS0617 CSS06-Suicidal Behavior Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Suicidal behavior was present during the Baseline - Suicidal
assessment period? Behavior
C111555 CSS0618A CSS06-Most Recent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Date Baseline - Most recent attempt date. Baseline - Most Recent
C111556 CSS0618B CSS06-Most Recent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Damage Baseline - Most recent attempt actual lethality/medical Baseline - Most Recent
C111557 CSS0618C CSS06-Most Recent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Potential Baseline - Most recent attempt potential lethality. Baseline - Most Recent
Lethality
page 267 of 1925

C111336 CSS06TC
Code Value
C111558 CSS0619A CSS06-Most Lethal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Date Baseline - Most lethal attempt date. Baseline - Most Lethal
C111559 CSS0619B CSS06-Most Lethal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Damage Baseline - Most lethal attempt actual lethality/medical Baseline - Most Lethal
C111560 CSS0619C CSS06-Most Lethal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Potential Baseline - Most lethal attempt potential lethality. Baseline - Most Lethal
Lethality
C111561 CSS0620A CSS06-First Attempt Date Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Initial/first attempt date. Baseline - First Suicide
Attempt Date
C111562 CSS0620B CSS06-First Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Damage Baseline - Initial/first attempt actual lethality/medical Baseline - First Suicide
C111563 CSS0620C CSS06-First Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Potential Baseline - Initial/first attempt potential lethality. Baseline - First Suicide
Attempt Potential
Lethality
page 268 of 1925

CSS06TN (Columbia-Suicide Severity Rating Scale Children's Baseline Questionnaire Test Name)
C111335 CSS06TN
Code Value
C111549 CSS06-Aborted Attempt CSS06-Aborted Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Has there been a time when you started to do Baseline - Aborted
life or kill yourself) but you changed your mind (stopped
yourself) before you actually did anything? What did you
do?
C111551 CSS06-Aborted Attempt, CSS06-Aborted Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Describe Baseline - Description of aborted attempt. Baseline - Description of
C111541 CSS06-Actual Attempt CSS06-Actual Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Did you ever do anything to try to kill yourself Baseline - Actual Suicide
or make yourself not alive anymore? What did you do? Attempt
Did you ever hurt yourself on purpose? Why did you do
that?
C111543 CSS06-Actual Attempt, CSS06-Actual Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Describe Baseline - Description of actual attempt. Baseline - Description of
C111562 CSS06-First Attempt CSS06-First Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Damage Damage Baseline - Initial/first attempt actual lethality/medical Baseline - First Suicide
C111561 CSS06-First Attempt Date CSS06-First Attempt Date Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Initial/first attempt date. Baseline - First Suicide
Attempt Date
Potential Potential Baseline - Initial/first attempt potential lethality. Baseline - First Suicide
Attempt Potential
Lethality
C111540 CSS06-Frequency, Write CSS06-Frequency, Write Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Response Response Baseline - Frequency, write response. Baseline - Frequency,
Write Response
C111531 CSS06-Idea, No Intent, CSS06-Idea, No Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
No Plan No Plan Baseline - Have you thought about how you would do Baseline - Active Suicidal
that or how you would make yourself not alive anymore Ideation with Any
(kill yourself)? What did you think about? Methods (Not Plan)
No Plan, Describe No Plan, Describe Baseline - Description of active suicidal ideation with any Baseline - Description of
Act
C111534 CSS06-Ideation With CSS06-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Intent No Plan Descr Intent No Plan Descr Baseline - Description of active suicidal ideation with Baseline - Description of
Intent, No Plan Intent, No Plan Baseline - When you thought about making yourself not Baseline - Active Suicidal
alive anymore (or killing yourself), did you think that this Ideation with Some
was something you might actually do? This is different Intent to Act, without
from (as opposed to) having the thoughts but knowing Specific Plan
you wouldn't do anything about it.
Plan/Intent Plan/Intent Baseline - Have you ever decided how or when you would Baseline - Active Suicidal
make yourself not alive anymore/kill yourself? Have you Ideation with Specific
ever planned out (worked out the details of) how you Plan and Intent
would do it? What was your plan? When you made this
plan (or worked out these details), was any part of you
thinking about actually doing it?
Plan/Intent, Descr Plan/Intent, Descr Baseline - Description of active suicidal ideation with Baseline - Description of
Intent
page 269 of 1925

C111335 CSS06TN
Code Value
C111546 CSS06-Interrupted CSS06-Interrupted Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Attempt Baseline - Has there been a time when you started to do Baseline - Interrupted
life or kill yourself) but someone or something stopped
you before you actually did anything? What did you do?
Attempt, Describe Attempt, Describe Baseline - Description of interrupted attempt. Baseline - Description of
Interrupted Suicide
Attempt
C111559 CSS06-Most Lethal CSS06-Most Lethal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Damage Attempt Damage Baseline - Most lethal attempt actual lethality/medical Baseline - Most Lethal
Attempt Date Attempt Date Baseline - Most lethal attempt date. Baseline - Most Lethal
Attempt Potential Attempt Potential Baseline - Most lethal attempt potential lethality. Baseline - Most Lethal
Lethality
C111556 CSS06-Most Recent CSS06-Most Recent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Damage Attempt Damage Baseline - Most recent attempt actual lethality/medical Baseline - Most Recent
Attempt Date Attempt Date Baseline - Most recent attempt date. Baseline - Most Recent
Attempt Potential Attempt Potential Baseline - Most recent attempt potential lethality. Baseline - Most Recent
Lethality
C111537 CSS06-Most Severe CSS06-Most Severe Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Ideation Ideation Baseline - Most severe ideation. Baseline - Most Severe
Ideation
Ideation, Description Ideation, Description Baseline - Description of most severe ideation. Baseline - Describe Most
Severe Ideation
Ideation, Frequency Ideation, Frequency Baseline - How many times have you had these thoughts? Baseline - Frequency of
C111530 CSS06-Non-Specific CSS06-Non-Specific Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Suicid Thought, Descr Suicid Thought, Descr Baseline - Description of non-specific active suicidal Baseline - Description of
Suicidal Thoughts
C111529 CSS06-Non-Specific CSS06-Non-Specific Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Suicidal Thought Suicidal Thought Baseline - Have you thought about doing something to Baseline - Non-Specific
make yourself not alive anymore? Have you had any Active Suicidal Thoughts
thoughts about killing yourself?
C111544 CSS06-Non-suicidal Self- CSS06-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
injurious Behav injurious Behav Baseline - Has subject engaged in non-suicidal self- Baseline - Non-suicidal
injurious behavior? Self-injurious Behavior
C111550 CSS06-Number of CSS06-Number of Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Aborted Attempts Aborted Attempts Baseline - Total number of aborted attempts. Baseline - Number of
C111542 CSS06-Number of Actual CSS06-Number of Actual Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempts Attempts Baseline - Total number of actual attempts. Baseline - Number of
Interrupt Attempts Interrupt Attempts Baseline - Total number of interrupted attempts. Baseline - Number of
Interrupted Suicide
Attempts
C111552 CSS06-Preparatory CSS06-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Acts/Behavior Acts/Behavior Baseline - Have you done anything to get ready to make Baseline - Preparatory
yourself not alive anymore (to end your life or kill Acts or Behaviors Toward
yourself) - like giving things away, writing a goodbye Suicide Attempt
note, getting things you need to kill yourself?
page 270 of 1925

C111335 CSS06TN
Code Value
Acts/Behavior, Descr Acts/Behavior, Descr Baseline - Description of preparatory acts or behavior. Baseline - Description of
Preparatory Acts or
Attempt
C111545 CSS06-Self-injur Behav, CSS06-Self-injur Behav, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Intent Unknown Intent Unknown Baseline - Has subject engaged in self-injurious behavior, Baseline - Self-injurious
intent unknown? Behavior, Intent Unknown
C111554 CSS06-Suicidal Behavior CSS06-Suicidal Behavior Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Suicidal behavior was present during the Baseline - Suicidal
assessment period? Behavior
C111527 CSS06-Wish to be Dead CSS06-Wish to be Dead Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline - Have you thought about being dead or what it Baseline - Wish to be
would be like to be dead? Have you wished you were Dead
dead or wished you could go to sleep and never wake up?
Do you ever wish you weren't alive anymore?
C111528 CSS06-Wish to be Dead, CSS06-Wish to be Dead, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Describe Baseline - Description of wishing to be dead. Baseline - Description of
Wish to be Dead
page 271 of 1925

CSS07TC (Columbia-Suicide Severity Rating Scale Children's Baseline/Screening Questionnaire Test
Code)
C111338 CSS07TC
Code Value
C111385 CSS0701A CSS07-Wish to be Dead- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Life Baseline/Screening - Have you thought about being dead Baseline/Screening - Wish
or what it would be like to be dead? Have you wished you to be Dead (Lifetime)
were dead or wished you could go to sleep and never
wake up? Do you ever wish you weren't alive anymore?
(Lifetime).
C111386 CSS0701B CSS07-Wish to be Dead- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
P6M Baseline/Screening - Have you thought about being dead Baseline/Screening - Wish
or what it would be like to be dead? Have you wished you to be Dead (Past 6
were dead or wished you could go to sleep and never Months)
(Past 6 Months).
C111387 CSS0701C CSS07-Wish to be Dead, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Baseline/Screening - Description of wishing to be dead. Baseline/Screening -
Dead
C111388 CSS0702A CSS07-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Thought-Life Baseline/Screening - Have you thought about doing Baseline/Screening -
something to make yourself not alive anymore? Have you Non-Specific Active
had any thoughts about killing yourself? (Lifetime). Suicidal Thoughts
(Lifetime)
C111389 CSS0702B CSS07-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Thought-P6M Baseline/Screening - Have you thought about doing Baseline/Screening -
had any thoughts about killing yourself? (Past 6 Months). Suicidal Thoughts (Past 6
Months)
C111390 CSS0702C CSS07-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Thought, Describe Baseline/Screening - Description of non-specific active Baseline/Screening -
suicidal thoughts. Description of Non-
Thoughts
C111391 CSS0703A CSS07-Idea, No Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
No Plan-Life Baseline/Screening - Have you thought about how you Baseline/Screening -
would do that or how you would make yourself not alive Active Suicidal Ideation
anymore (kill yourself)? What did you think about? with Any Methods (Not
(Lifetime). Plan) without Intent to
Act (Lifetime)
C111392 CSS0703B CSS07-Idea, No Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
No Plan-P6M Baseline/Screening - Have you thought about how you Baseline/Screening -
anymore (kill yourself)? What did you think about? (Past with Any Methods (Not
6 Months). Plan) without Intent to
Act (Past 6 Months)
C111393 CSS0703C CSS07-Idea, No Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
No Plan, Describe Baseline/Screening - Description of active suicidal Baseline/Screening -
ideation with any methods (not plan) without intent to Description of Active
act. Suicidal Ideation with Any
Methods (Not Plan)
C111394 CSS0704A CSS07-Idea, Intent, No Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Plan-Life Baseline/Screening - When you thought about making Baseline/Screening -
yourself not alive anymore (or killing yourself), did you Active Suicidal Ideation
think that this was something you might actually do? This with Some Intent to Act,
is different from (as opposed to) having the thoughts but without Specific Plan
knowing you wouldn't do anything about it. (Lifetime). (Lifetime)
C111395 CSS0704B CSS07-Idea, Intent, No Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Plan-P6M Baseline/Screening - When you thought about making Baseline/Screening -
knowing you wouldn't do anything about it. (Past 6 (Past 6 Months)
Months).
C111396 CSS0704C CSS07-Idea, Intent, No Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Plan, Describe Baseline/Screening - Description of active suicidal Baseline/Screening -
ideation with some intent to act, without specific plan. Description of Active
Some Intent to Act,
page 272 of 1925

C111338 CSS07TC
Code Value
C111397 CSS0705A CSS07-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Life Baseline/Screening - Have you ever decided how or when Baseline/Screening -
you would make yourself not alive anymore/kill yourself? Active Suicidal Ideation
Have you ever planned out (worked out the details of) with Specific Plan and
how you would do it? What was your plan? When you Intent (Lifetime)
made this plan (or worked out these details), was any
part of you thinking about actually doing it? (Lifetime).
C111398 CSS0705B CSS07-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
P6M Baseline/Screening - Have you ever decided how or when Baseline/Screening -
how you would do it? What was your plan? When you Intent (Past 6 Months)
part of you thinking about actually doing it? (Past 6
Months).
C111399 CSS0705C CSS07-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Baseline/Screening - Description of active suicidal Baseline/Screening -
ideation with specific plan and intent. Description of Active
C111400 CSS0706A CSS07-Most Severe Idea Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Most severe ideation. Baseline/Screening - Most
Severe Ideation
C111401 CSS0706B CSS07-Most Severe Idea, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Desc Baseline/Screening - Description of most severe ideation. Baseline/Screening -
Ideation
C111402 CSS0707A CSS07-Most Severe Idea, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Frequency-Life Baseline/Screening - How many times have you had Baseline/Screening -
these thoughts? (Lifetime). Frequency of Most Severe
Ideation (Lifetime)
C111403 CSS0707B CSS07-Most Severe Idea, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Frequency-P6M Baseline/Screening - How many times have you had Baseline/Screening -
these thoughts? (Past 6 Months). Frequency of Most Severe
C111404 CSS0707C CSS07-Frequency, Write Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Response Baseline/Screening - Frequency, write response. Baseline/Screening -
Frequency, Write
Response
C111405 CSS0708 CSS07-Actual Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Did you ever do anything to try to Baseline/Screening -
kill yourself or make yourself not alive anymore? What Actual Suicide Attempt
did you do? Did you ever hurt yourself on purpose? Why
did you do that?
C111406 CSS0709 CSS07-Number of Actual Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempts Baseline/Screening - Total number of actual attempts. Baseline/Screening -
Attempts
C111407 CSS0709A CSS07-Actual Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Baseline/Screening - Description of actual attempt. Baseline/Screening -
Suicide Attempt
C111408 CSS0710 CSS07-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
injur Behav Baseline/Screening - Has subject engaged in non-suicidal Baseline/Screening -
self-injurious behavior? Non-suicidal Self-
injurious Behavior
C111409 CSS0711 CSS07-Self-injur Behav, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Intent Unknown Baseline - Has subject engaged in self-injurious behavior, Baseline/Screening - Self-
intent unknown? injurious Behavior, Intent
Unknown
C111410 CSS0712 CSS07-Interrupted Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Baseline/Screening - Has there been a time when you Baseline/Screening -
started to do something to make yourself not alive Interrupted Suicide
anymore (end your life or kill yourself) but someone or Attempt
something stopped you before you actually did anything?
What did you do?
Interrupt Attempts Baseline/Screening - Total number of interrupted Baseline/Screening -
attempts. Number of Interrupted
Suicide Attempts
page 273 of 1925

C111338 CSS07TC
Code Value
C111412 CSS0713A CSS07-Interrupted Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt, Describe Baseline/Screening - Description of interrupted attempt. Baseline/Screening -
Suicide Attempt
C111413 CSS0714 CSS07-Aborted Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Has there been a time when you Baseline/Screening -
started to do something to make yourself not alive Aborted Suicide Attempt
anymore (end your life or kill yourself) but you changed
your mind (stopped yourself) before you actually did
anything? What did you do?
Aborted Attempts Baseline/Screening - Total number of aborted attempts. Baseline/Screening -
Number of Aborted
Suicide Attempts
C111415 CSS0715A CSS07-Aborted Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Baseline/Screening - Description of aborted attempt. Baseline/Screening -
Suicide Attempt
C111416 CSS0716 CSS07-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Acts/Behavior Baseline/Screening - Have you done anything to get Baseline/Screening -
ready to make yourself not alive anymore (to end your Preparatory Acts or
life or kill yourself) - like giving things away, writing a Behaviors Toward Suicide
goodbye note, getting things you need to kill yourself? Attempt
C111417 CSS0716A CSS07-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Acts/Behavior, Descr Baseline/Screening - Description of preparatory acts or Baseline/Screening -
behavior. Description of Preparatory
Suicide Attempt
C111418 CSS0717 CSS07-Suicidal Behavior Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Suicidal behavior was present during Baseline/Screening -
the assessment period? Suicidal Behavior
C111419 CSS0718A CSS07-Most Recent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Date Baseline/Screening - Most recent attempt date. Baseline/Screening - Most
Recent Suicide Attempt
Date
C111420 CSS0718B CSS07-Most Recent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Damage Baseline/Screening - Most recent attempt actual Baseline/Screening - Most
lethality/medical damage. Recent Suicide Attempt
Damage
C111421 CSS0718C CSS07-Most Recent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Potential Baseline/Screening - Most recent attempt potential Baseline/Screening - Most
lethality. Recent Suicide Attempt
Potential Lethality
C111422 CSS0719A CSS07-Most Lethal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Date Baseline/Screening - Most lethal attempt date. Baseline/Screening - Most
Lethal Suicide Attempt
Date
C111423 CSS0719B CSS07-Most Lethal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Damage Baseline/Screening - Most lethal attempt actual Baseline/Screening - Most
lethality/medical damage. Lethal Suicide Attempt
Damage
C111424 CSS0719C CSS07-Most Lethal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempt Potential Baseline/Screening - Most lethal attempt potential Baseline/Screening - Most
lethality. Lethal Suicide Attempt
Potential Lethality
C111425 CSS0720A CSS07-First Attempt Date Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Initial/first attempt date. Baseline/Screening - First
C111426 CSS0720B CSS07-First Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Damage Baseline/Screening - Initial/first attempt actual Baseline/Screening - First
lethality/medical damage. Suicide Attempt Actual
C111427 CSS0720C CSS07-First Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Potential Baseline/Screening - Initial/first attempt potential Baseline/Screening - First
lethality. Suicide Attempt Potential
Lethality
page 274 of 1925

CSS07TN (Columbia-Suicide Severity Rating Scale Children's Baseline/Screening Questionnaire Test
Name)
C111337 CSS07TN
Code Value
C111413 CSS07-Aborted Attempt CSS07-Aborted Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Has there been a time when you Baseline/Screening -
started to do something to make yourself not alive Aborted Suicide Attempt
anymore (end your life or kill yourself) but you changed
your mind (stopped yourself) before you actually did
C111415 CSS07-Aborted Attempt, CSS07-Aborted Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Describe Baseline/Screening - Description of aborted attempt. Baseline/Screening -
Suicide Attempt
C111405 CSS07-Actual Attempt CSS07-Actual Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Did you ever do anything to try to Baseline/Screening -
kill yourself or make yourself not alive anymore? What Actual Suicide Attempt
did you do? Did you ever hurt yourself on purpose? Why
did you do that?
C111407 CSS07-Actual Attempt, CSS07-Actual Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Describe Baseline/Screening - Description of actual attempt. Baseline/Screening -
Suicide Attempt
Damage Damage Baseline/Screening - Initial/first attempt actual Baseline/Screening - First
C111425 CSS07-First Attempt Date CSS07-First Attempt Date Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Initial/first attempt date. Baseline/Screening - First
Potential Potential Baseline/Screening - Initial/first attempt potential Baseline/Screening - First
Lethality
C111404 CSS07-Frequency, Write CSS07-Frequency, Write Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Response Response Baseline/Screening - Frequency, write response. Baseline/Screening -
Frequency, Write
Response
C111396 CSS07-Idea, Intent, No CSS07-Idea, Intent, No Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Plan, Describe Plan, Describe Baseline/Screening - Description of active suicidal Baseline/Screening -
ideation with some intent to act, without specific plan. Description of Active
Some Intent to Act,
Plan-Life Plan-Life Baseline/Screening - When you thought about making Baseline/Screening -
knowing you wouldn't do anything about it. (Lifetime). (Lifetime)
Plan-P6M Plan-P6M Baseline/Screening - When you thought about making Baseline/Screening -
knowing you wouldn't do anything about it. (Past 6 (Past 6 Months)
Months).
No Plan, Describe No Plan, Describe Baseline/Screening - Description of active suicidal Baseline/Screening -
ideation with any methods (not plan) without intent to Description of Active
act. Suicidal Ideation with Any
Methods (Not Plan)
No Plan-Life No Plan-Life Baseline/Screening - Have you thought about how you Baseline/Screening -
anymore (kill yourself)? What did you think about? with Any Methods (Not
(Lifetime). Plan) without Intent to
Act (Lifetime)
page 275 of 1925

C111337 CSS07TN
Code Value
No Plan-P6M No Plan-P6M Baseline/Screening - Have you thought about how you Baseline/Screening -
anymore (kill yourself)? What did you think about? (Past with Any Methods (Not
6 Months). Plan) without Intent to
Act (Past 6 Months)
C111399 CSS07-Idea, Plan, Intent, CSS07-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Describe Baseline/Screening - Description of active suicidal Baseline/Screening -
ideation with specific plan and intent. Description of Active
C111397 CSS07-Idea, Plan, Intent- CSS07-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Life Life Baseline/Screening - Have you ever decided how or when Baseline/Screening -
how you would do it? What was your plan? When you Intent (Lifetime)
part of you thinking about actually doing it? (Lifetime).
C111398 CSS07-Idea, Plan, Intent- CSS07-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
P6M P6M Baseline/Screening - Have you ever decided how or when Baseline/Screening -
how you would do it? What was your plan? When you Intent (Past 6 Months)
part of you thinking about actually doing it? (Past 6
Months).
Attempt Attempt Baseline/Screening - Has there been a time when you Baseline/Screening -
started to do something to make yourself not alive Interrupted Suicide
anymore (end your life or kill yourself) but someone or Attempt
something stopped you before you actually did anything?
What did you do?
Attempt, Describe Attempt, Describe Baseline/Screening - Description of interrupted attempt. Baseline/Screening -
Suicide Attempt
Attempt Damage Attempt Damage Baseline/Screening - Most lethal attempt actual Baseline/Screening - Most
lethality/medical damage. Lethal Suicide Attempt
Damage
Attempt Date Attempt Date Baseline/Screening - Most lethal attempt date. Baseline/Screening - Most
Lethal Suicide Attempt
Date
Attempt Potential Attempt Potential Baseline/Screening - Most lethal attempt potential Baseline/Screening - Most
lethality. Lethal Suicide Attempt
Potential Lethality
Attempt Damage Attempt Damage Baseline/Screening - Most recent attempt actual Baseline/Screening - Most
lethality/medical damage. Recent Suicide Attempt
Damage
Attempt Date Attempt Date Baseline/Screening - Most recent attempt date. Baseline/Screening - Most
Recent Suicide Attempt
Date
Attempt Potential Attempt Potential Baseline/Screening - Most recent attempt potential Baseline/Screening - Most
lethality. Recent Suicide Attempt
Potential Lethality
C111400 CSS07-Most Severe Idea CSS07-Most Severe Idea Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Most severe ideation. Baseline/Screening - Most
Severe Ideation
C111401 CSS07-Most Severe Idea, CSS07-Most Severe Idea, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Desc Desc Baseline/Screening - Description of most severe ideation. Baseline/Screening -
Ideation
page 276 of 1925

C111337 CSS07TN
Code Value
Frequency-Life Frequency-Life Baseline/Screening - How many times have you had Baseline/Screening -
these thoughts? (Lifetime). Frequency of Most Severe
Ideation (Lifetime)
Frequency-P6M Frequency-P6M Baseline/Screening - How many times have you had Baseline/Screening -
these thoughts? (Past 6 Months). Frequency of Most Severe
C111390 CSS07-Non-Spec Suicid CSS07-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Thought, Describe Thought, Describe Baseline/Screening - Description of non-specific active Baseline/Screening -
suicidal thoughts. Description of Non-
Thoughts
Thought-Life Thought-Life Baseline/Screening - Have you thought about doing Baseline/Screening -
had any thoughts about killing yourself? (Lifetime). Suicidal Thoughts
(Lifetime)
Thought-P6M Thought-P6M Baseline/Screening - Have you thought about doing Baseline/Screening -
had any thoughts about killing yourself? (Past 6 Months). Suicidal Thoughts (Past 6
Months)
C111408 CSS07-Non-suicidal Self- CSS07-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
injur Behav injur Behav Baseline/Screening - Has subject engaged in non-suicidal Baseline/Screening -
self-injurious behavior? Non-suicidal Self-
injurious Behavior
Aborted Attempts Aborted Attempts Baseline/Screening - Total number of aborted attempts. Baseline/Screening -
Number of Aborted
Suicide Attempts
C111406 CSS07-Number of Actual CSS07-Number of Actual Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Attempts Attempts Baseline/Screening - Total number of actual attempts. Baseline/Screening -
Attempts
Interrupt Attempts Interrupt Attempts Baseline/Screening - Total number of interrupted Baseline/Screening -
attempts. Number of Interrupted
Suicide Attempts
Acts/Behavior Acts/Behavior Baseline/Screening - Have you done anything to get Baseline/Screening -
ready to make yourself not alive anymore (to end your Preparatory Acts or
life or kill yourself) - like giving things away, writing a Behaviors Toward Suicide
goodbye note, getting things you need to kill yourself? Attempt
Acts/Behavior, Descr Acts/Behavior, Descr Baseline/Screening - Description of preparatory acts or Baseline/Screening -
behavior. Description of Preparatory
Suicide Attempt
C111409 CSS07-Self-injur Behav, CSS07-Self-injur Behav, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Intent Unknown Intent Unknown Baseline - Has subject engaged in self-injurious behavior, Baseline/Screening - Self-
intent unknown? injurious Behavior, Intent
Unknown
C111418 CSS07-Suicidal Behavior CSS07-Suicidal Behavior Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Baseline/Screening - Suicidal behavior was present during Baseline/Screening -
the assessment period? Suicidal Behavior
C111387 CSS07-Wish to be Dead, CSS07-Wish to be Dead, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Describe Describe Baseline/Screening - Description of wishing to be dead. Baseline/Screening -
Dead
C111385 CSS07-Wish to be Dead- CSS07-Wish to be Dead- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
Life Life Baseline/Screening - Have you thought about being dead Baseline/Screening - Wish
or what it would be like to be dead? Have you wished you to be Dead (Lifetime)
were dead or wished you could go to sleep and never
(Lifetime).
page 277 of 1925

C111337 CSS07TN
Code Value
C111386 CSS07-Wish to be Dead- CSS07-Wish to be Dead- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's
P6M P6M Baseline/Screening - Have you thought about being dead Baseline/Screening - Wish
or what it would be like to be dead? Have you wished you to be Dead (Past 6
were dead or wished you could go to sleep and never Months)
(Past 6 Months).
page 278 of 1925

CSS08TC (Columbia-Suicide Severity Rating Scale Children's Since Last Visit Questionnaire Test Code)
C111340 CSS08TC
Code Value
C111428 CSS0801 CSS08-Wish to be Dead Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Have you thought about being dead Last Visit - Wish to be
or what it would be like to be dead? Have you wished Dead
you were dead or wished you could go to sleep and
never wake up? Do you ever wish you weren't alive
anymore?
C111429 CSS0801A CSS08-Wish to be Dead, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Describe Since Last Visit - Description of wishing to be dead. Last Visit - Description of
Wish to be Dead
C111430 CSS0802 CSS08-Non-Specific Suicidal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Thought Since Last Visit - Have you thought about doing Last Visit - Non-Specific
something to make yourself not alive anymore? Have Active Suicidal Thoughts
you had any thoughts about killing yourself?
C111431 CSS0802A CSS08-Non-Specific Suicid Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Thought, Descr Since Last Visit - Description of non-specific active Last Visit - Description of
suicidal thoughts. Non-Specific Active
Suicidal Thoughts
C111432 CSS0803 CSS08-Idea, No Intent, No Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Plan Since Last Visit - Have you thought about how you Last Visit - Active Suicidal
would do that or how you would make yourself not Ideation with Any
alive anymore (kill yourself)? What did you think Methods (Not Plan)
about? without Intent to Act
C111433 CSS0803A CSS08-Idea, No Intent, No Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Plan, Describe Since Last Visit - Description of active suicidal ideation Last Visit - Description of
with any methods (not plan) without intent to act. Active Suicidal Ideation
Act
C111434 CSS0804 CSS08-Ideation With Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
No Plan Since Last Visit - When you thought about making Last Visit - Active Suicidal
yourself not alive anymore (or killing yourself), did you Ideation with Some
think that this was something you might actually do? Intent to Act, without
This is different from (as opposed to) having the Specific Plan
thoughts but knowing you wouldn't do anything about
it.
C111435 CSS0804A CSS08-Ideation With Intent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
No Plan Descr Since Last Visit - Description of active suicidal ideation Last Visit - Description of
with some intent to act, without specific plan. Active Suicidal Ideation
C111436 CSS0805 CSS08-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Plan/Intent Since Last Visit - Have you decided how or when you Last Visit - Active Suicidal
would make yourself not alive anymore/kill yourself? Ideation with Specific
Have you planned out (worked out the details of) how Plan and Intent
you would do it? What was your plan? When you made
this plan (or worked out these details), was any part of
you thinking about actually doing it?
C111437 CSS0805A CSS08-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Plan/Intent, Descr Since Last Visit - Description of active suicidal ideation Last Visit - Description of
with specific plan and intent. Active Suicidal Ideation
Intent
C111438 CSS0806 CSS08-Most Severe Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Ideation Since Last Visit - Most severe ideation. Last Visit - Most Severe
Ideation
C111439 CSS0806A CSS08-Most Severe Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Ideation, Description Since Last Visit - Description of most severe ideation. Last Visit - Describe Most
Severe Ideation
C111440 CSS0807 CSS08-Most Severe Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Ideation, Frequency Since Last Visit - How many times have you had these Last Visit - Frequency of
thoughts? Most Severe Ideation
C111441 CSS0807A CSS08-Frequency, Write Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Response Since Last Visit - Frequency, write response. Last Visit - Frequency,
Write Response
page 279 of 1925

C111340 CSS08TC
Code Value
C111442 CSS0808 CSS08-Actual Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Did you do anything to try to kill Last Visit - Actual Suicide
yourself or make yourself not alive anymore? What did Attempt
you do? Did you hurt yourself on purpose? Why did you
do that?
C111443 CSS0809 CSS08-Number of Actual Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Attempts Since Last Visit - Total number of actual attempts. Last Visit - Number of
C111444 CSS0809A CSS08-Actual Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Describe Since Last Visit - Description of actual attempt. Last Visit - Description of
C111445 CSS0810 CSS08-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
injurious Behav Since Last Visit - Has subject engaged in non-suicidal Last Visit - Non-suicidal
self-injurious behavior? Self-injurious Behavior
C111446 CSS0811 CSS08-Self-injur Behav, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Intent Unknown Since Last Visit - Has subject engaged in self-injurious Last Visit - Self-injurious
behavior, intent unknown? Behavior, Intent Unknown
C111447 CSS0812 CSS08-Interrupted Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Has there been a time when you Last Visit - Interrupted
started to do something to make yourself not alive Suicide Attempt
anymore (end your life or kill yourself) but someone or
something stopped you before you actually did
C111448 CSS0813 CSS08-Number of Interrupt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Attempts Since Last Visit - Total number of interrupted attempts. Last Visit - Number of
Interrupted Suicide
Attempts
C111449 CSS0813A CSS08-Interrupted Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Describe Since Last Visit - Description of interrupted attempt. Last Visit - Description of
Interrupted Suicide
Attempt
C111450 CSS0814 CSS08-Aborted/Self- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Interrupted Attempt Since Last Visit - Has there been a time when you Last Visit - Aborted or
started to do something to make yourself not alive Self-interrupted Suicide
anymore (end your life or kill yourself) but you Attempt
changed your mind (stopped yourself) before you
actually did anything? What did you do?
C111451 CSS0815 CSS08-Number of Aborted Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Attempts Since Last Visit - Total number of aborted or self- Last Visit - Number of
interrupted attempts. Aborted or Self-
interrupted Suicide
Attempts
C111452 CSS0815A CSS08-Aborted Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Describe Since Last Visit - Description of aborted attempt or Last Visit - Description of
self-interrupted attempt. Aborted or Self-
interrupted Suicide
Attempt
C111453 CSS0816 CSS08-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Acts/Behavior Since Last Visit - Have you done anything to get ready Last Visit - Preparatory
to make yourself not alive anymore (to end your life or Acts or Behaviors Toward
kill yourself) - like giving things away, writing a Suicide Attempt
goodbye note, getting things you need to kill yourself?
C111454 CSS0816A CSS08-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Acts/Behavior, Descr Since Last Visit - Description of preparatory acts or Last Visit - Description of
behavior. Preparatory Acts or
Attempt
C111455 CSS0817 CSS08-Suicidal Behavior Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Suicidal behavior was present during Last Visit - Suicidal
the assessment period? Behavior
C111456 CSS0818 CSS08-Suicide Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Suicide. Last Visit - Suicide
C111457 CSS0819A CSS08-Most Lethal Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Date Since Last Visit - Most lethal attempt date. Last Visit - Most Lethal
C111458 CSS0819B CSS08-Most Lethal Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Damage Since Last Visit - Most lethal attempt actual Last Visit - Most Lethal
page 280 of 1925

C111340 CSS08TC
Code Value
C111459 CSS0819C CSS08-Most Lethal Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Potential Since Last Visit - Most lethal attempt potential lethality. Last Visit - Most Lethal
Lethality
page 281 of 1925

CSS08TN (Columbia-Suicide Severity Rating Scale Children's Since Last Visit Questionnaire Test Name)
C111339 CSS08TN
NCI CDISC Submission Value CDISC Synonym CDISC Definition NCI Preferred Term
Code
C111452 CSS08-Aborted Attempt, CSS08-Aborted Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Describe Describe Since Last Visit - Description of aborted attempt or Last Visit - Description of
self-interrupted attempt. Aborted or Self-
interrupted Suicide
Attempt
C111450 CSS08-Aborted/Self- CSS08-Aborted/Self- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Interrupted Attempt Interrupted Attempt Since Last Visit - Has there been a time when you Last Visit - Aborted or
started to do something to make yourself not alive Self-interrupted Suicide
anymore (end your life or kill yourself) but you Attempt
changed your mind (stopped yourself) before you
actually did anything? What did you do?
C111442 CSS08-Actual Attempt CSS08-Actual Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Did you do anything to try to kill Last Visit - Actual Suicide
yourself or make yourself not alive anymore? What Attempt
did you do? Did you hurt yourself on purpose? Why
did you do that?
C111444 CSS08-Actual Attempt, CSS08-Actual Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Describe Describe Since Last Visit - Description of actual attempt. Last Visit - Description of
C111441 CSS08-Frequency, Write CSS08-Frequency, Write Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Response Response Since Last Visit - Frequency, write response. Last Visit - Frequency,
Write Response
C111432 CSS08-Idea, No Intent, No CSS08-Idea, No Intent, No Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Plan Plan Since Last Visit - Have you thought about how you Last Visit - Active Suicidal
would do that or how you would make yourself not Ideation with Any
alive anymore (kill yourself)? What did you think Methods (Not Plan)
about? without Intent to Act
C111433 CSS08-Idea, No Intent, No CSS08-Idea, No Intent, No Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Plan, Describe Plan, Describe Since Last Visit - Description of active suicidal Last Visit - Description of
ideation with any methods (not plan) without intent Active Suicidal Ideation
to act. with Any Methods (Not
Act
C111435 CSS08-Ideation With Intent CSS08-Ideation With Intent Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
No Plan Descr No Plan Descr Since Last Visit - Description of active suicidal Last Visit - Description of
ideation with some intent to act, without specific Active Suicidal Ideation
plan. with Some Intent to Act,
C111434 CSS08-Ideation With Intent, CSS08-Ideation With Intent, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
No Plan No Plan Since Last Visit - When you thought about making Last Visit - Active Suicidal
yourself not alive anymore (or killing yourself), did Ideation with Some
you think that this was something you might actually Intent to Act, without
do? This is different from (as opposed to) having the Specific Plan
thoughts but knowing you wouldn't do anything
about it.
C111436 CSS08-Ideation With CSS08-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Plan/Intent Plan/Intent Since Last Visit - Have you decided how or when you Last Visit - Active Suicidal
would make yourself not alive anymore/kill yourself? Ideation with Specific
Have you planned out (worked out the details of) Plan and Intent
how you would do it? What was your plan? When
you made this plan (or worked out these details),
was any part of you thinking about actually doing it?
C111437 CSS08-Ideation With CSS08-Ideation With Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Plan/Intent, Descr Plan/Intent, Descr Since Last Visit - Description of active suicidal Last Visit - Description of
ideation with specific plan and intent. Active Suicidal Ideation
Intent
C111447 CSS08-Interrupted Attempt CSS08-Interrupted Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Has there been a time when you Last Visit - Interrupted
started to do something to make yourself not alive Suicide Attempt
anymore (end your life or kill yourself) but someone
or something stopped you before you actually did
C111449 CSS08-Interrupted Attempt, CSS08-Interrupted Attempt, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Describe Describe Since Last Visit - Description of interrupted attempt. Last Visit - Description of
Interrupted Suicide
Attempt
page 282 of 1925

C111339 CSS08TN
Code
C111458 CSS08-Most Lethal Attempt CSS08-Most Lethal Attempt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Damage Damage Since Last Visit - Most lethal attempt actual Last Visit - Most Lethal
Date Date Since Last Visit - Most lethal attempt date. Last Visit - Most Lethal
Potential Potential Since Last Visit - Most lethal attempt potential Last Visit - Most Lethal
Lethality
C111438 CSS08-Most Severe CSS08-Most Severe Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Ideation Ideation Since Last Visit - Most severe ideation. Last Visit - Most Severe
Ideation
Ideation, Description Ideation, Description Since Last Visit - Description of most severe Last Visit - Describe Most
ideation. Severe Ideation
Ideation, Frequency Ideation, Frequency Since Last Visit - How many times have you had Last Visit - Frequency of
these thoughts? Most Severe Ideation
C111431 CSS08-Non-Specific Suicid CSS08-Non-Specific Suicid Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Thought, Descr Thought, Descr Since Last Visit - Description of non-specific active Last Visit - Description of
suicidal thoughts. Non-Specific Active
Suicidal Thoughts
C111430 CSS08-Non-Specific Suicidal CSS08-Non-Specific Suicidal Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Thought Thought Since Last Visit - Have you thought about doing Last Visit - Non-Specific
something to make yourself not alive anymore? Have Active Suicidal Thoughts
you had any thoughts about killing yourself?
C111445 CSS08-Non-suicidal Self- CSS08-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
injurious Behav injurious Behav Since Last Visit - Has subject engaged in non-suicidal Last Visit - Non-suicidal
self-injurious behavior? Self-injurious Behavior
C111451 CSS08-Number of Aborted CSS08-Number of Aborted Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Attempts Attempts Since Last Visit - Total number of aborted or self- Last Visit - Number of
interrupted attempts. Aborted or Self-
interrupted Suicide
Attempts
C111443 CSS08-Number of Actual CSS08-Number of Actual Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Attempts Attempts Since Last Visit - Total number of actual attempts. Last Visit - Number of
C111448 CSS08-Number of Interrupt CSS08-Number of Interrupt Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Attempts Attempts Since Last Visit - Total number of interrupted Last Visit - Number of
attempts. Interrupted Suicide
Attempts
C111453 CSS08-Preparatory CSS08-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Acts/Behavior Acts/Behavior Since Last Visit - Have you done anything to get Last Visit - Preparatory
ready to make yourself not alive anymore (to end Acts or Behaviors Toward
your life or kill yourself) - like giving things away, Suicide Attempt
writing a goodbye note, getting things you need to
kill yourself?
C111454 CSS08-Preparatory CSS08-Preparatory Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Acts/Behavior, Descr Acts/Behavior, Descr Since Last Visit - Description of preparatory acts or Last Visit - Description of
behavior. Preparatory Acts or
Attempt
C111446 CSS08-Self-injur Behav, CSS08-Self-injur Behav, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Intent Unknown Intent Unknown Since Last Visit - Has subject engaged in self- Last Visit - Self-injurious
injurious behavior, intent unknown? Behavior, Intent Unknown
C111455 CSS08-Suicidal Behavior CSS08-Suicidal Behavior Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Suicidal behavior was present Last Visit - Suicidal
during the assessment period? Behavior
C111456 CSS08-Suicide CSS08-Suicide Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Suicide. Last Visit - Suicide
page 283 of 1925

C111339 CSS08TN
Code
C111428 CSS08-Wish to be Dead CSS08-Wish to be Dead Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Since Last Visit - Have you thought about being dead Last Visit - Wish to be
or what it would be like to be dead? Have you Dead
wished you were dead or wished you could go to
sleep and never wake up? Do you ever wish you
weren't alive anymore?
C111429 CSS08-Wish to be Dead, CSS08-Wish to be Dead, Columbia-Suicide Severity Rating Scale Children's C-SSRS Children's Since
Describe Describe Since Last Visit - Description of wishing to be dead. Last Visit - Description of
Wish to be Dead
page 284 of 1925

CSS09TC (Columbia-Suicide Severity Rating Scale Screening Questionnaire Test Code)
C111342 CSS09TC
Code Value
C111460 CSS0901 CSS09-Wish to be Dead Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening - Wish
you wished you were dead or wished you could go to to be Dead
sleep and not wake up?
C111461 CSS0901A CSS09-Wish to be Dead, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Dead
C111462 CSS0902 CSS09-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening - Non-
Thought you actually had any thoughts of killing yourself? Specific Active Suicidal
Thoughts
C111463 CSS0902A CSS09-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Thought, Describe Description of non-specific active suicidal thoughts. Description of Non-
Thoughts
C111464 CSS0903 CSS09-Idea, No Intent, Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
No Plan you been thinking about how you might do this? Active Suicidal Ideation
Act
C111465 CSS0903A CSS09-Idea, No Intent, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
No Plan, Describe Description of active suicidal ideation with any methods Description of Active
(not plan) without intent to act. Suicidal Ideation with Any
Methods (Not Plan)
C111466 CSS0904 CSS09-Idea, Intent, No Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
Plan you had these thoughts and had some intention of acting Active Suicidal Ideation
on them? with Some Intent to Act,
C111467 CSS0904A CSS09-Idea, Intent, No Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Plan, Describe Description of active suicidal ideation with some intent to Description of Active
act, without specific plan. Suicidal Ideation with
Some Intent to Act,
C111468 CSS0905 CSS09-Idea, Plan, Intent Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
you started to work out or worked out the details of how Active Suicidal Ideation
to kill yourself? Do you intend to carry out this plan? with Specific Plan and
Intent
C111469 CSS0905A CSS09-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Describe Description of active suicidal ideation with specific plan Description of Active
and intent. Suicidal Ideation with
C111470 CSS0906 CSS09-Most Severe Idea Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
severe ideation. Severe Ideation
C111471 CSS0906A CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Desc Description of most severe ideation. Describe Most Severe
Ideation
C111472 CSS0907 CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - How C-SSRS Screening -
Frequency many times have you had these thoughts? Frequency of Most Severe
Ideation
C111473 CSS0908 CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - When C-SSRS Screening -
Duration you have the thoughts, how long do they last? Duration of Most Severe
Ideation
C111474 CSS0909 CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Controllability Could/can you stop thinking about killing yourself or Controllability of Most
wanting to die if you want to? Severe Ideation
C111475 CSS0910 CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - Are C-SSRS Screening -
Deterrents there things-anyone or anything (e.g., family, religion, Deterrents to Most
page 285 of 1925

C111342 CSS09TC
Code Value
C111476 CSS0911 CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - What C-SSRS Screening -
Reasons sort of reasons did you have for thinking about wanting to Reasons for Most Severe
both?
C111477 CSS0912 CSS09-Actual Attempt Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
you made a suicide attempt? Have you done anything to Actual Suicide Attempt
C111478 CSS0913 CSS09-Number of Actual Columbia-Suicide Severity Rating Scale Screening - Total C-SSRS Screening -
Attempts number of actual attempts. Number of Actual Suicide
Attempts
C111479 CSS0913A CSS09-Actual Attempt, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Suicide Attempt
C111480 CSS0914 CSS09-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Screening - Has C-SSRS Screening - Non-
injur Behav subject engaged in non-suicidal self-injurious behavior? suicidal Self-injurious
Behavior
C111481 CSS0915 CSS09-Interrupted Columbia-Suicide Severity Rating Scale Screening - Has C-SSRS Screening -
Attempt there been a time when you started to do something to Interrupted Suicide
end your life but someone or something stopped you Attempt
before you actually did anything?
C111482 CSS0916 CSS09-Number of Columbia-Suicide Severity Rating Scale Screening - Total C-SSRS Screening -
Interrupt Attempts number of interrupted attempts. Number of Interrupted
Suicide Attempts
C111483 CSS0916A CSS09-Interrupted Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Suicide Attempt
C111484 CSS0917 CSS09-Aborted Attempt Columbia-Suicide Severity Rating Scale Screening - Has C-SSRS Screening -
C111485 CSS0918 CSS09-Number of Columbia-Suicide Severity Rating Scale Screening - Total C-SSRS Screening -
Aborted Attempts number of aborted attempts. Number of Aborted
Suicide Attempts
C111486 CSS0918A CSS09-Aborted Attempt, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Suicide Attempt
C111487 CSS0919 CSS09-Preparatory Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
Acts/Behavior you taken any steps towards making a suicide attempt or Preparatory Acts or
C111488 CSS0919A CSS09-Preparatory Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Suicide Attempt
C111489 CSS0920 CSS09-Suicidal Behavior Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
period?
C111490 CSS0921A CSS09-Most Recent Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
Attempt Date recent attempt date. Recent Suicide Attempt
Date
C111491 CSS0921B CSS09-Most Recent Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
Attempt Damage recent attempt actual lethality/medical damage. Recent Suicide Attempt
Damage
C111492 CSS0921C CSS09-Most Recent Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
Attempt Potential recent attempt potential lethality. Recent Suicide Attempt
Potential Lethality
C111493 CSS0922A CSS09-Most Lethal Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
Attempt Date lethal attempt date. Lethal Suicide Attempt
Date
page 286 of 1925

C111342 CSS09TC
Code Value
C111494 CSS0922B CSS09-Most Lethal Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
Attempt Damage lethal attempt actual lethality/medical damage. Lethal Suicide Attempt
Damage
C111495 CSS0922C CSS09-Most Lethal Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
Attempt Potential lethal attempt potential lethality. Lethal Suicide Attempt
Potential Lethality
C111496 CSS0923A CSS09-First Attempt Date Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening - First
C111497 CSS0923B CSS09-First Attempt Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening - First
Damage Initial/first attempt actual lethality/medical damage. Suicide Attempt Actual
C111498 CSS0923C CSS09-First Attempt Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening - First
Potential Initial/first attempt potential lethality. Suicide Attempt Potential
Lethality
page 287 of 1925

CSS09TN (Columbia-Suicide Severity Rating Scale Screening Questionnaire Test Name)
C111341 CSS09TN
Code Value
C111484 CSS09-Aborted Attempt CSS09-Aborted Attempt Columbia-Suicide Severity Rating Scale Screening - Has C-SSRS Screening -
C111486 CSS09-Aborted Attempt, CSS09-Aborted Attempt, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Suicide Attempt
C111477 CSS09-Actual Attempt CSS09-Actual Attempt Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
you made a suicide attempt? Have you done anything to Actual Suicide Attempt
C111479 CSS09-Actual Attempt, CSS09-Actual Attempt, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Suicide Attempt
C111497 CSS09-First Attempt CSS09-First Attempt Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening - First
Damage Damage Initial/first attempt actual lethality/medical damage. Suicide Attempt Actual
C111496 CSS09-First Attempt Date CSS09-First Attempt Date Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening - First
C111498 CSS09-First Attempt CSS09-First Attempt Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening - First
Potential Potential Initial/first attempt potential lethality. Suicide Attempt Potential
Lethality
C111466 CSS09-Idea, Intent, No CSS09-Idea, Intent, No Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
Plan Plan you had these thoughts and had some intention of acting Active Suicidal Ideation
on them? with Some Intent to Act,
C111467 CSS09-Idea, Intent, No CSS09-Idea, Intent, No Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Plan, Describe Plan, Describe Description of active suicidal ideation with some intent to Description of Active
act, without specific plan. Suicidal Ideation with
Some Intent to Act,
C111464 CSS09-Idea, No Intent, CSS09-Idea, No Intent, Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
No Plan No Plan you been thinking about how you might do this? Active Suicidal Ideation
Act
C111465 CSS09-Idea, No Intent, CSS09-Idea, No Intent, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
No Plan, Describe No Plan, Describe Description of active suicidal ideation with any methods Description of Active
(not plan) without intent to act. Suicidal Ideation with Any
Methods (Not Plan)
C111468 CSS09-Idea, Plan, Intent CSS09-Idea, Plan, Intent Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
you started to work out or worked out the details of how Active Suicidal Ideation
to kill yourself? Do you intend to carry out this plan? with Specific Plan and
Intent
C111469 CSS09-Idea, Plan, Intent, CSS09-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Describe Describe Description of active suicidal ideation with specific plan Description of Active
and intent. Suicidal Ideation with
C111481 CSS09-Interrupted CSS09-Interrupted Columbia-Suicide Severity Rating Scale Screening - Has C-SSRS Screening -
Attempt Attempt there been a time when you started to do something to Interrupted Suicide
end your life but someone or something stopped you Attempt
before you actually did anything?
C111483 CSS09-Interrupted CSS09-Interrupted Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Suicide Attempt
C111494 CSS09-Most Lethal CSS09-Most Lethal Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
Attempt Damage Attempt Damage lethal attempt actual lethality/medical damage. Lethal Suicide Attempt
Damage
Attempt Date Attempt Date lethal attempt date. Lethal Suicide Attempt
Date
page 288 of 1925

C111341 CSS09TN
Code Value
Attempt Potential Attempt Potential lethal attempt potential lethality. Lethal Suicide Attempt
Potential Lethality
C111491 CSS09-Most Recent CSS09-Most Recent Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
Attempt Damage Attempt Damage recent attempt actual lethality/medical damage. Recent Suicide Attempt
Damage
Attempt Date Attempt Date recent attempt date. Recent Suicide Attempt
Date
Attempt Potential Attempt Potential recent attempt potential lethality. Recent Suicide Attempt
Potential Lethality
C111470 CSS09-Most Severe Idea CSS09-Most Severe Idea Columbia-Suicide Severity Rating Scale Screening - Most C-SSRS Screening - Most
severe ideation. Severe Ideation
C111474 CSS09-Most Severe Idea, CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Controllability Controllability Could/can you stop thinking about killing yourself or Controllability of Most
wanting to die if you want to? Severe Ideation
C111471 CSS09-Most Severe Idea, CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Desc Desc Description of most severe ideation. Describe Most Severe
Ideation
C111475 CSS09-Most Severe Idea, CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - Are C-SSRS Screening -
Deterrents Deterrents there things-anyone or anything (e.g., family, religion, Deterrents to Most
C111473 CSS09-Most Severe Idea, CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - When C-SSRS Screening -
Duration Duration you have the thoughts, how long do they last? Duration of Most Severe
Ideation
C111472 CSS09-Most Severe Idea, CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - How C-SSRS Screening -
Frequency Frequency many times have you had these thoughts? Frequency of Most Severe
Ideation
C111476 CSS09-Most Severe Idea, CSS09-Most Severe Idea, Columbia-Suicide Severity Rating Scale Screening - What C-SSRS Screening -
Reasons Reasons sort of reasons did you have for thinking about wanting to Reasons for Most Severe
both?
C111462 CSS09-Non-Spec Suicid CSS09-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening - Non-
Thought Thought you actually had any thoughts of killing yourself? Specific Active Suicidal
Thoughts
C111463 CSS09-Non-Spec Suicid CSS09-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Thought, Describe Thought, Describe Description of non-specific active suicidal thoughts. Description of Non-
Thoughts
C111480 CSS09-Non-suicidal Self- CSS09-Non-suicidal Self- Columbia-Suicide Severity Rating Scale Screening - Has C-SSRS Screening - Non-
injur Behav injur Behav subject engaged in non-suicidal self-injurious behavior? suicidal Self-injurious
Behavior
C111485 CSS09-Number of CSS09-Number of Columbia-Suicide Severity Rating Scale Screening - Total C-SSRS Screening -
Aborted Attempts Aborted Attempts number of aborted attempts. Number of Aborted
Suicide Attempts
C111478 CSS09-Number of Actual CSS09-Number of Actual Columbia-Suicide Severity Rating Scale Screening - Total C-SSRS Screening -
Attempts Attempts number of actual attempts. Number of Actual Suicide
Attempts
C111482 CSS09-Number of CSS09-Number of Columbia-Suicide Severity Rating Scale Screening - Total C-SSRS Screening -
Interrupt Attempts Interrupt Attempts number of interrupted attempts. Number of Interrupted
Suicide Attempts
C111487 CSS09-Preparatory CSS09-Preparatory Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening -
Acts/Behavior Acts/Behavior you taken any steps towards making a suicide attempt or Preparatory Acts or
C111488 CSS09-Preparatory CSS09-Preparatory Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Suicide Attempt
page 289 of 1925

C111341 CSS09TN
Code Value
C111489 CSS09-Suicidal Behavior CSS09-Suicidal Behavior Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
period?
C111460 CSS09-Wish to be Dead CSS09-Wish to be Dead Columbia-Suicide Severity Rating Scale Screening - Have C-SSRS Screening - Wish
you wished you were dead or wished you could go to to be Dead
sleep and not wake up?
C111461 CSS09-Wish to be Dead, CSS09-Wish to be Dead, Columbia-Suicide Severity Rating Scale Screening - C-SSRS Screening -
Dead
page 290 of 1925

CSS10TC (Columbia-Suicide Severity Rating Scale Pediatric/Cognitively Impaired Lifetime/Recent
C113848 CSS10TC
Code Value

Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
thought about being dead or what it would be like to be Impaired Lifetime/Recent
dead? Have you wished you were dead or wished you - Wish to be Dead
could go to sleep and never wake up? Do you ever wish (Lifetime)
you weren't alive anymore? (Lifetime).

P1M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
dead? Have you wished you were dead or wished you - Wish to be Dead (Past 1
could go to sleep and never wake up? Do you ever wish Month)
you weren't alive anymore? (Past 1 Month).

Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of wishing to be dead. Impaired Lifetime/Recent
- Description of Wish to
be Dead

Thought-Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
thought about doing something to make yourself not alive Impaired Lifetime/Recent
anymore? Have you had any thoughts about killing - Non-Specific Active
yourself? (Lifetime). Suicidal Thoughts
(Lifetime)

Thought-P1M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
yourself? (Past 1 Month). Suicidal Thoughts (Past 1
Month)

Thought, Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of non-specific active suicidal thoughts. Impaired Lifetime/Recent
- Description of Non-
Thoughts

No Plan-Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
thought about how you would do that or how you would Impaired Lifetime/Recent
make yourself not alive anymore (kill yourself)? What did - Active Suicidal Ideation
you think about? (Lifetime). With Any Methods (Not
Act (Lifetime)

No Plan-P1M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
you think about? (Past 1 Month). With Any Methods (Not
Act (Past 1 Month)

No Plan, Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of active suicidal ideation with any methods Impaired Lifetime/Recent
(not plan) without intent to act. - Description of Active
Suicidal Ideation With
Any Methods (Not Plan)

Plan-Life Pediatric/Cognitively Impaired Lifetime/Recent - When Pediatric/Cognitively
you thought about making yourself not alive anymore (or Impaired Lifetime/Recent
killing yourself), did you think that this was something - Active Suicidal Ideation
you might actually do? This is different from (as opposed With Some Intent to Act,
to) having the thoughts but knowing you wouldn't do Without Specific Plan
anything about it. (Lifetime). (Lifetime)

Plan-P1M Pediatric/Cognitively Impaired Lifetime/Recent - When Pediatric/Cognitively
anything about it. (Past 1 Month). (Past 1 Month)
page 291 of 1925

C113848 CSS10TC
Code Value

Plan, Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of active suicidal ideation with some intent to Impaired Lifetime/Recent
act, without specific plan. - Description of Active
Some Intent to Act,
Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
ever decided how or when you would make yourself not Impaired Lifetime/Recent
alive anymore/kill yourself? Have you ever planned out - Active Suicidal Ideation
(worked out the details of) how you would do it? What With Specific Plan and
was your plan? When you made this plan (or worked out Intent (Lifetime)
these details), was any part of you thinking about
actually doing it? (Lifetime).
P1M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
was your plan? When you made this plan (or worked out Intent (Past 1 Month)
actually doing it? (Past 1 Month).
Description of active suicidal ideation with specific plan Impaired Lifetime/Recent
and intent. - Description of Active
Life Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
severe ideation. (Lifetime). Impaired Lifetime/Recent
- Most Severe Ideation
(Lifetime)
Desc-Life Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of most severe ideation. (Lifetime). Impaired Lifetime/Recent
- Describe Most Severe
Ideation (Lifetime)
P1M Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
severe ideation. (Past 1 Month). Impaired Lifetime/Recent
(Past 1 Month)
Desc-P1M Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of most severe ideation. (Past 1 Month). Impaired Lifetime/Recent
Ideation (Past 1 Month)
Frequency-Life Pediatric/Cognitively Impaired Lifetime/Recent - How Pediatric/Cognitively
many times have you had these thoughts? (Lifetime). Impaired Lifetime/Recent
- Frequency (Lifetime)
Frequency-P1M Pediatric/Cognitively Impaired Lifetime/Recent - How Pediatric/Cognitively
many times have you had these thoughts? (Past 1 Impaired Lifetime/Recent
Month). - Frequency (Past 1
Month)
C113910 CSS1007C CSS10-Frequency, Write Columbia-Suicide Severity Rating Scale C-SSRS

Response Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Frequency, write response. Impaired Lifetime/Recent
- Frequency Write
Response
C113911 CSS1008A CSS10-Actual Attempt- Columbia-Suicide Severity Rating Scale C-SSRS

Life Pediatric/Cognitively Impaired Lifetime/Recent - Did you Pediatric/Cognitively
ever do anything to try to kill yourself or make yourself Impaired Lifetime/Recent
not alive anymore? What did you do? Did you ever hurt - Actual Suicide Attempt
yourself on purpose? Why did you do that? (Lifetime). (Lifetime)
page 292 of 1925

C113848 CSS10TC
Code Value
C113912 CSS1008B CSS10-Actual Attempt- Columbia-Suicide Severity Rating Scale C-SSRS

P3M Pediatric/Cognitively Impaired Lifetime/Recent - Did you Pediatric/Cognitively
yourself on purpose? Why did you do that? (Past 3 (Past 3 Month)
Months).
C113913 CSS1009A CSS10-Number of Actual Columbia-Suicide Severity Rating Scale C-SSRS

Attempts-Life Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of actual attempts. (Lifetime). Impaired Lifetime/Recent
- Number of Actual
Suicide Attempts
(Lifetime)
C113914 CSS1009B CSS10-Number of Actual Columbia-Suicide Severity Rating Scale C-SSRS

Attempts-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of actual attempts. (Past 3 Months). Impaired Lifetime/Recent
- Number of Actual
Suicide Attempts (Past 3
Months)
C113915 CSS1009C CSS10-Actual Attempt, Columbia-Suicide Severity Rating Scale C-SSRS

Description of actual attempt. Impaired Lifetime/Recent
- Description of Actual
Suicide Attempt
C113916 CSS1010A CSS10-Non-suicidal Self- Columbia-Suicide Severity Rating Scale C-SSRS

injur Behav-Life Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
subject engaged in non-suicidal self-injurious behavior? Impaired Lifetime/Recent
(Lifetime). - Non-suicidal Self-
injurious Behavior
(Lifetime)
C113917 CSS1010B CSS10-Non-suicidal Self- Columbia-Suicide Severity Rating Scale C-SSRS

injur Behav-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
(Past 3 Months). - Non-suicidal Self-
injurious Behavior (Past 3
Months)
C113918 CSS1011A CSS10-Self-injur Behav, Columbia-Suicide Severity Rating Scale C-SSRS

Intent Unk-Life Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
subject engaged in self-injurious behavior, intent Impaired Lifetime/Recent
unknown? (Lifetime). - Self-injurious Behavior,
Intent Unknown
(Lifetime)
C113919 CSS1011B CSS10-Self-injur Behav, Columbia-Suicide Severity Rating Scale C-SSRS

Intent Unk-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
unknown? (Past 3 Months). - Self-injurious Behavior,
Intent Unknown (Past 3
Months)

Attempt-Life Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
there been a time when you started to do something to Impaired Lifetime/Recent
make yourself not alive anymore (end your life or kill - Interrupted Suicide
yourself) but someone or something stopped you before Attempt (Lifetime)
you actually did anything? What did you do? (Lifetime).
C113921 CSS1012B CSS10-Interrupted Columbia-Suicide Severity Rating Scale C-SSRS

Attempt-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
yourself) but someone or something stopped you before Attempt (Past 3 Months)
you actually did anything? What did you do? (Past 3
Months).

Interrupt Attempts-Life Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of interrupted attempts. (Lifetime). Impaired Lifetime/Recent
- Number of Interrupted
Suicide Attempts
(Lifetime)

Interrupt Attempts-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of interrupted attempts. (Past 3 Months). Impaired Lifetime/Recent
Months)
page 293 of 1925

C113848 CSS10TC
Code Value
C113924 CSS1013C CSS10-Interrupted Columbia-Suicide Severity Rating Scale C-SSRS

Attempt, Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of interrupted attempt. Impaired Lifetime/Recent
- Description of
Interrupted Suicide
Attempt
C113925 CSS1014A CSS10-Aborted Attempt- Columbia-Suicide Severity Rating Scale C-SSRS

Life Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
make yourself not alive anymore (end your life or kill - Aborted or Self-
yourself) but you changed your mind (stopped yourself) interrupted Suicide
before you actually did anything? What did you do? Attempt (Lifetime)
(Lifetime).
C113926 CSS1014B CSS10-Aborted Attempt- Columbia-Suicide Severity Rating Scale C-SSRS

P3M Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
before you actually did anything? What did you do? (Past Attempt (Past 3 Months)
3 Months).

Aborted Attempts-Life Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of aborted or self-interrupted attempts. Impaired Lifetime/Recent
(Lifetime). - Number of Aborted or
Self-interrupted Suicide
Attempt (Lifetime)

Aborted Attempts-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of aborted or self-interrupted attempts. (Past 3 Impaired Lifetime/Recent
Months). - Number of Aborted or
Attempt (Past 3 Months)
C113929 CSS1015C CSS10-Aborted Attempt, Columbia-Suicide Severity Rating Scale C-SSRS

Description of aborted or self-interrupted attempt. Impaired Lifetime/Recent
- Description of Aborted
Suicide Attempt

Acts/Behavior-Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
done anything to get ready to make yourself not alive Impaired Lifetime/Recent
anymore (to end your life or kill yourself) - like giving - Preparatory Acts or
things away, writing a goodbye note, getting things you Behaviors Toward Suicide
need to kill yourself? (Lifetime). Attempt (Lifetime)
C113931 CSS1016B CSS10-Preparatory Columbia-Suicide Severity Rating Scale C-SSRS

Acts/Behavior-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
need to kill yourself? (Past 3 Months). Attempt (Past 3 Months)
C113932 CSS1016C CSS10-Preparatory Columbia-Suicide Severity Rating Scale C-SSRS

Acts/Behavior, Descr Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of preparatory acts or behavior. Impaired Lifetime/Recent
- Description of
Preparatory Acts or
Attempt
C113933 CSS1017A CSS10-Suicidal Behavior- Columbia-Suicide Severity Rating Scale C-SSRS

Life Pediatric/Cognitively Impaired Lifetime/Recent - Suicidal Pediatric/Cognitively
behavior was present during the assessment period? Impaired Lifetime/Recent
(Lifetime). - Suicidal Behavior
(Lifetime)
C113934 CSS1017B CSS10-Suicidal Behavior- Columbia-Suicide Severity Rating Scale C-SSRS

P3M Pediatric/Cognitively Impaired Lifetime/Recent - Suicidal Pediatric/Cognitively
(Past 3 Months). - Suicidal Behavior (Past
3 Months)

Attempt Date Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
recent attempt date. Impaired Lifetime/Recent
- Most Recent Suicide
Attempt Date
page 294 of 1925

C113848 CSS10TC
Code Value

Attempt Damage Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
recent attempt actual lethality/medical damage. Impaired Lifetime/Recent
Attempt Actual

Attempt Potential Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
recent attempt potential lethality. Impaired Lifetime/Recent
Attempt Potential
Lethality

Attempt Date Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
lethal attempt date. Impaired Lifetime/Recent
- Most Lethal Suicide
Attempt Date

Attempt Damage Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
lethal attempt actual lethality/medical damage. Impaired Lifetime/Recent
Attempt Actual

Attempt Potential Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
lethal attempt potential lethality. Impaired Lifetime/Recent
Attempt Potential
Lethality
Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Initial/first attempt date. Impaired Lifetime/Recent
- First Suicide Attempt
Date

Damage Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Initial/first attempt actual lethality/medical damage. Impaired Lifetime/Recent
Damage

Potential Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Initial/first attempt potential lethality. Impaired Lifetime/Recent
Potential Lethality
page 295 of 1925

CSS10TN (Columbia-Suicide Severity Rating Scale Pediatric/Cognitively Impaired Lifetime/Recent
C113847 CSS10TN
Code Value
Describe Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of aborted or self-interrupted attempt. Impaired Lifetime/Recent
- Description of Aborted
Suicide Attempt
Life Life Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
before you actually did anything? What did you do? Attempt (Lifetime)
(Lifetime).
P3M P3M Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
before you actually did anything? What did you do? (Past Attempt (Past 3 Months)
3 Months).
Description of actual attempt. Impaired Lifetime/Recent
- Description of Actual
Suicide Attempt
Life Life Pediatric/Cognitively Impaired Lifetime/Recent - Did you Pediatric/Cognitively
yourself on purpose? Why did you do that? (Lifetime). (Lifetime)
P3M P3M Pediatric/Cognitively Impaired Lifetime/Recent - Did you Pediatric/Cognitively
yourself on purpose? Why did you do that? (Past 3 (Past 3 Month)
Months).
Damage Damage Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Initial/first attempt actual lethality/medical damage. Impaired Lifetime/Recent
Damage
Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Initial/first attempt date. Impaired Lifetime/Recent
Date
Potential Potential Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Initial/first attempt potential lethality. Impaired Lifetime/Recent
Potential Lethality
C113910 CSS10-Frequency, Write CSS10-Frequency, Write Columbia-Suicide Severity Rating Scale C-SSRS
Response Response Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Frequency, write response. Impaired Lifetime/Recent
- Frequency Write
Response
Plan, Describe Plan, Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of active suicidal ideation with some intent to Impaired Lifetime/Recent
act, without specific plan. - Description of Active
Some Intent to Act,
page 296 of 1925

C113847 CSS10TN
Code Value
Plan-Life Plan-Life Pediatric/Cognitively Impaired Lifetime/Recent - When Pediatric/Cognitively
anything about it. (Lifetime). (Lifetime)
Plan-P1M Plan-P1M Pediatric/Cognitively Impaired Lifetime/Recent - When Pediatric/Cognitively
anything about it. (Past 1 Month). (Past 1 Month)
No Plan, Describe No Plan, Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of active suicidal ideation with any methods Impaired Lifetime/Recent
(not plan) without intent to act. - Description of Active
Any Methods (Not Plan)
No Plan-Life No Plan-Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
you think about? (Lifetime). With Any Methods (Not
Act (Lifetime)
No Plan-P1M No Plan-P1M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
you think about? (Past 1 Month). With Any Methods (Not
Act (Past 1 Month)
Description of active suicidal ideation with specific plan Impaired Lifetime/Recent
and intent. - Description of Active
Life Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
was your plan? When you made this plan (or worked out Intent (Lifetime)
actually doing it? (Lifetime).
P1M P1M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
was your plan? When you made this plan (or worked out Intent (Past 1 Month)
actually doing it? (Past 1 Month).

Attempt, Describe Attempt, Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of interrupted attempt. Impaired Lifetime/Recent
- Description of
Interrupted Suicide
Attempt

Attempt-Life Attempt-Life Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
yourself) but someone or something stopped you before Attempt (Lifetime)
you actually did anything? What did you do? (Lifetime).

Attempt-P3M Attempt-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
yourself) but someone or something stopped you before Attempt (Past 3 Months)
you actually did anything? What did you do? (Past 3
Months).
page 297 of 1925

C113847 CSS10TN
Code Value
Attempt Damage Attempt Damage Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
lethal attempt actual lethality/medical damage. Impaired Lifetime/Recent
Attempt Actual
Attempt Date Attempt Date Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
lethal attempt date. Impaired Lifetime/Recent
Attempt Date
Attempt Potential Attempt Potential Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
lethal attempt potential lethality. Impaired Lifetime/Recent
Attempt Potential
Lethality
Attempt Damage Attempt Damage Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
recent attempt actual lethality/medical damage. Impaired Lifetime/Recent
Attempt Actual
Attempt Date Attempt Date Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
recent attempt date. Impaired Lifetime/Recent
Attempt Date
Attempt Potential Attempt Potential Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
recent attempt potential lethality. Impaired Lifetime/Recent
Attempt Potential
Lethality
Desc-Life Desc-Life Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of most severe ideation. (Lifetime). Impaired Lifetime/Recent
Ideation (Lifetime)
Desc-P1M Desc-P1M Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of most severe ideation. (Past 1 Month). Impaired Lifetime/Recent
Ideation (Past 1 Month)
Frequency-Life Frequency-Life Pediatric/Cognitively Impaired Lifetime/Recent - How Pediatric/Cognitively
many times have you had these thoughts? (Lifetime). Impaired Lifetime/Recent
- Frequency (Lifetime)
Frequency-P1M Frequency-P1M Pediatric/Cognitively Impaired Lifetime/Recent - How Pediatric/Cognitively
many times have you had these thoughts? (Past 1 Impaired Lifetime/Recent
Month). - Frequency (Past 1
Month)
Life Life Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
severe ideation. (Lifetime). Impaired Lifetime/Recent
(Lifetime)
P1M P1M Pediatric/Cognitively Impaired Lifetime/Recent - Most Pediatric/Cognitively
severe ideation. (Past 1 Month). Impaired Lifetime/Recent
(Past 1 Month)
Thought, Describe Thought, Describe Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of non-specific active suicidal thoughts. Impaired Lifetime/Recent
- Description of Non-
Thoughts
page 298 of 1925

C113847 CSS10TN
Code Value
Thought-Life Thought-Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
yourself? (Lifetime). Suicidal Thoughts
(Lifetime)
Thought-P1M Thought-P1M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
yourself? (Past 1 Month). Suicidal Thoughts (Past 1
Month)
injur Behav-Life injur Behav-Life Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
(Lifetime). - Non-suicidal Self-
injurious Behavior
(Lifetime)
injur Behav-P3M injur Behav-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
(Past 3 Months). - Non-suicidal Self-
injurious Behavior (Past 3
Months)

Aborted Attempts-Life Aborted Attempts-Life Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of aborted or self-interrupted attempts. Impaired Lifetime/Recent
(Lifetime). - Number of Aborted or
Attempt (Lifetime)

Aborted Attempts-P3M Aborted Attempts-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of aborted or self-interrupted attempts. (Past 3 Impaired Lifetime/Recent
Months). - Number of Aborted or
Attempt (Past 3 Months)
Attempts-Life Attempts-Life Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of actual attempts. (Lifetime). Impaired Lifetime/Recent
- Number of Actual
Suicide Attempts
(Lifetime)
Attempts-P3M Attempts-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of actual attempts. (Past 3 Months). Impaired Lifetime/Recent
- Number of Actual
Months)

Interrupt Attempts-Life Interrupt Attempts-Life Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of interrupted attempts. (Lifetime). Impaired Lifetime/Recent
Suicide Attempts
(Lifetime)

Interrupt Attempts-P3M Interrupt Attempts-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Total Pediatric/Cognitively
number of interrupted attempts. (Past 3 Months). Impaired Lifetime/Recent
Months)

Acts/Behavior, Descr Acts/Behavior, Descr Pediatric/Cognitively Impaired Lifetime/Recent - Pediatric/Cognitively
Description of preparatory acts or behavior. Impaired Lifetime/Recent
- Description of
Preparatory Acts or
Attempt

Acts/Behavior-Life Acts/Behavior-Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
need to kill yourself? (Lifetime). Attempt (Lifetime)
page 299 of 1925

C113847 CSS10TN
Code Value

Acts/Behavior-P3M Acts/Behavior-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
need to kill yourself? (Past 3 Months). Attempt (Past 3 Months)
C113918 CSS10-Self-injur Behav, CSS10-Self-injur Behav, Columbia-Suicide Severity Rating Scale C-SSRS
Intent Unk-Life Intent Unk-Life Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
unknown? (Lifetime). - Self-injurious Behavior,
Intent Unknown
(Lifetime)
C113919 CSS10-Self-injur Behav, CSS10-Self-injur Behav, Columbia-Suicide Severity Rating Scale C-SSRS
Intent Unk-P3M Intent Unk-P3M Pediatric/Cognitively Impaired Lifetime/Recent - Has Pediatric/Cognitively
unknown? (Past 3 Months). - Self-injurious Behavior,
Intent Unknown (Past 3
Months)
Life Life Pediatric/Cognitively Impaired Lifetime/Recent - Suicidal Pediatric/Cognitively
(Lifetime). - Suicidal Behavior
(Lifetime)
P3M P3M Pediatric/Cognitively Impaired Lifetime/Recent - Suicidal Pediatric/Cognitively
(Past 3 Months). - Suicidal Behavior (Past
3 Months)
Description of wishing to be dead. Impaired Lifetime/Recent
- Description of Wish to
be Dead
Life Life Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
dead? Have you wished you were dead or wished you - Wish to be Dead
could go to sleep and never wake up? Do you ever wish (Lifetime)
you weren't alive anymore? (Lifetime).
P1M P1M Pediatric/Cognitively Impaired Lifetime/Recent - Have you Pediatric/Cognitively
dead? Have you wished you were dead or wished you - Wish to be Dead (Past 1
could go to sleep and never wake up? Do you ever wish Month)
you weren't alive anymore? (Past 1 Month).
page 300 of 1925

CSS11TC (Columbia-Suicide Severity Rating Scale Lifetime/Recent Version Questionnaire Test Code)
C117989 CSS11TC
Code Value
C118019 CSS1101A CSS11-Wish to be Dead- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Version - Have you wished you were dead or wished you Version - Wish to be Dead
could go to sleep and not wake up? (Lifetime). (Lifetime)
C118020 CSS1101B CSS11-Wish to be Dead- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P1M Version - Have you wished you were dead or wished you Version - Wish to be Dead
could go to sleep and not wake up? (Past 1 Month). (Past 1 Month)
C118021 CSS1101C CSS11-Wish to be Dead, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Describe Version - Description of wishing to be dead. Version - Description of
Wish to be Dead
C118022 CSS1102A CSS11-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Thought-Life Version - Have you actually had any thoughts of killing Version - Non-Specific
yourself? (Lifetime). Active Suicidal Thoughts
(Lifetime)
C118023 CSS1102B CSS11-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Thought-P1M Version - Have you actually had any thoughts of killing Version - Non-Specific
yourself? (Past 1 Month). Active Suicidal Thoughts
(Past 1 Months)
C118024 CSS1102C CSS11-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Thought, Describe Version - Description of non-specific active suicidal Version - Description of
Suicidal Thoughts
C118025 CSS1103A CSS11-Idea, No Intent, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
No Plan-Life Version - Have you been thinking about how you might Version - Active Suicidal
do this? (Lifetime). Ideation with Any
Methods (Not Plan)
(Lifetime)
C118026 CSS1103B CSS11-Idea, No Intent, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
No Plan-P1M Version - Have you been thinking about how you might Version - Active Suicidal
do this? (Past 1 Month). Ideation with Any
Methods (Not Plan)
(Past 1 Month)
C118027 CSS1103C CSS11-Idea, No Intent, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
No Plan, Describe Version - Description of active suicidal ideation with any Version - Description of
Act
C118028 CSS1104A CSS11-Idea, Intent, No Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Plan-Life Version - Have you had these thoughts and had some Version - Active Suicidal
intention of acting on them? (Lifetime). Ideation with Some
C118029 CSS1104B CSS11-Idea, Intent, No Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Plan-P1M Version - Have you had these thoughts and had some Version - Active Suicidal
intention of acting on them? (Past 1 Month). Ideation with Some
Specific Plan (Past 1
Month)
C118030 CSS1104C CSS11-Idea, Intent, No Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Plan, Describe Version - Description of active suicidal ideation with some Version - Description of
intent to act, without specific plan. Active Suicidal Ideation
C118031 CSS1105A CSS11-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Version - Have you started to work out or worked out the Version - Active Suicidal
details of how to kill yourself? Do you intend to carry out Ideation with Specific
this plan? (Lifetime). Plan and Intent (Lifetime)
C118032 CSS1105B CSS11-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P1M Version - Have you started to work out or worked out the Version - Active Suicidal
this plan? (Past 1 Month). Plan and Intent (Past 1
Month)
page 301 of 1925

C117989 CSS11TC
Code Value
C118033 CSS1105C CSS11-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Describe Version - Description of active suicidal ideation with Version - Description of
Intent
C118034 CSS1106A CSS11-Most Severe Idea- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Version - Most severe ideation. (Lifetime). Version - Most Severe
Ideation (Lifetime)
C118035 CSS1106B CSS11-Most Severe Idea, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Desc-Life Version - Description of most severe ideation. (Lifetime). Version - Describe Most
Severe Ideation
(Lifetime)
C118036 CSS1106C CSS11-Most Severe Idea- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Recent-P1M Version - Most severe ideation. (Recent - Past 1 Month). Version - Recent Most
Month)
C118037 CSS1106D CSS11-Most Severe Idea, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Desc-Recent-P1M Version - Description of most severe ideation. (Recent - Version - Describe Recent
Past 1 Month). Most Severe Ideation
(Past 1 Month)
C118038 CSS1107A CSS11-Most Severe Idea, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Frequency-Life Version - How many times have you had these thoughts? Version - Frequency of
(Lifetime)
Frequency-P1M Version - How many times have you had these thoughts? Version - Frequency of
(Past 1 Month). Most Severe Ideation
(Past 1 Month)
Duration-Life Version - When you have the thoughts how long do they Version - Duration of
last? (Lifetime). Most Severe Ideation
(Lifetime)
Duration-P1M Version - When you have the thoughts how long do they Version - Duration of
last? (Past 1 Month). Most Severe Ideation
(Past 1 Month)
Control-Life Version - Could/can you stop thinking about killing Version - Controllability of
yourself or wanting to die if you want to? (Lifetime). Most Severe Ideation
(Lifetime)
Control-P1M Version - Could/can you stop thinking about killing Version - Controllability of
yourself or wanting to die if you want to? (Past 1 Month). Most Severe Ideation
(Past 1 Month)
Deterrents-Life Version - Are there things - anyone or anything (e.g., Version - Deterrents to
wanting to die or acting on thoughts of committing (Lifetime)
suicide? (Lifetime).
Deterrents-P1M Version - Are there things - anyone or anything (e.g., Version - Deterrents to
wanting to die or acting on thoughts of committing (Past 1 Month)
suicide? (Past 1 Month).
Reasons-Life Version - What sort of reasons did you have for thinking Version - Reasons for
pain or stop the way you were feeling (in other words you (Lifetime)
from others? Or both? (Lifetime).
Reasons-P1M Version - What sort of reasons did you have for thinking Version - Reasons for
pain or stop the way you were feeling (in other words you (Past 1 Month)
from others? Or both? (Past 1 Month).
page 302 of 1925

C117989 CSS11TC
Code Value
C118048 CSS1112A CSS11-Actual Attempt- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Version - Have you made a suicide attempt? Have you Version - Actual Suicide
done anything to harm yourself? Have you done anything Attempt (Lifetime)
dangerous where you could have died? (Lifetime).
C118049 CSS1112B CSS11-Actual Attempt- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P3M Version - Have you made a suicide attempt? Have you Version - Actual Suicide
done anything to harm yourself? Have you done anything Attempt (Past 3 Months)
dangerous where you could have died? (Past 3 Months).
C118050 CSS1113A CSS11-Number of Actual Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempts-Life Version - Total number of actual attempts. (Lifetime). Version - Number of
(Lifetime)
C118051 CSS1113B CSS11-Number of Actual Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempts-P3M Version - Total number of actual attempts. (Past 3 Version - Number of
Months). Actual Suicide Attempts
(Past 3 Months)
C118052 CSS1113C CSS11-Actual Attempt, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Describe Version - Description of actual attempt. Version - Description of
C118053 CSS1114A CSS11-Non-suicid Self- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
injur Behav-Life Version - Has subject engaged in non-suicidal self- Version - Non-suicidal
injurious behavior? (Lifetime). Self-injurious Behavior
(Lifetime)
C118054 CSS1114B CSS11-Non-suicid Self- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
injur Behav-P3M Version - Has subject engaged in non-suicidal self- Version - Non-suicidal
injurious behavior? (Past 3 Months). Self-injurious Behavior
(Past 3 Months)
C118055 CSS1115A CSS11-Interrupted Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt-Life Version - Has there been a time when you started to do Version - Interrupted
something to end your life but someone or something Suicide Attempt
stopped you before you actually did anything? (Lifetime). (Lifetime)
C118056 CSS1115B CSS11-Interrupted Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt-P3M Version - Has there been a time when you started to do Version - Interrupted
something to end your life but someone or something Suicide Attempt (Past 3
stopped you before you actually did anything? (Past 3 Months)
Months).
C118057 CSS1116A CSS11-Num of Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Interrupted Attempts-Life Version - Total number of interrupted attempts. Version - Number of
(Lifetime). Interrupted Suicide
Attempts (Lifetime)
C118058 CSS1116B CSS11-Num of Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Interrupted Attempts- Version - Total number of interrupted attempts. (Past 3 Version - Number of
P3M Months). Interrupted Suicide
Attempts (Past 3 Months)
C118059 CSS1116C CSS11-Interrupted Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt, Describe Version - Description of interrupted attempt. Version - Description of
Interrupted Suicide
Attempt
C118060 CSS1117A CSS11-Aborted Attempt- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Version - Has there been a time when you started to do Version - Aborted Suicide
something to try to end your life but you stopped yourself Attempt (Lifetime)
before you actually did anything? (Lifetime).
C118061 CSS1117B CSS11-Aborted Attempt- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P3M Version - Has there been a time when you started to do Version - Aborted Suicide
something to try to end your life but you stopped yourself Attempt (Past 3 Months)
before you actually did anything? (Past 3 Months).
C118062 CSS1118A CSS11-Number of Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Aborted Attempts-Life Version - Total number of aborted or self-interrupted Version - Number of
attempts. (Lifetime). Aborted Suicide Attempts
(Lifetime)
C118063 CSS1118B CSS11-Number of Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Aborted Attempts-P3M Version - Total number of aborted or self-interrupted Version - Number of
attempts. (Past 3 Months). Aborted Suicide Attempts
(Past 3 Months)
C118064 CSS1118C CSS11-Aborted Attempt, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Describe Version - Description of aborted or self-interrupted Version - Description of
attempt. Aborted Suicide Attempt
page 303 of 1925

C117989 CSS11TC
Code Value
C118065 CSS1119A CSS11-Preparatory Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Acts/Behavior-Life Version - Have you taken any steps towards making a Version - Preparatory
collecting pills, getting a gun, giving valuables away or Suicide Attempt
writing a suicide note)? (Lifetime). (Lifetime)
C118066 CSS1119B CSS11-Preparatory Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Acts/Behavior-P3M Version - Have you taken any steps towards making a Version - Preparatory
collecting pills, getting a gun, giving valuables away or Suicide Attempt (Past 3
writing a suicide note)? (Past 3 Months). Months)
C118067 CSS1119C CSS11-Preparatory Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Acts/Behavior, Descr Version - Description of preparatory acts or behavior. Version - Description of
Preparatory Acts or
Attempt
C118068 CSS1120A CSS11-Suicidal Behavior- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Version - Suicidal behavior was present during the Version - Suicidal
assessment period? (Lifetime). Behavior (Lifetime)
C118069 CSS1120B CSS11-Suicidal Behavior- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P3M Version - Suicidal behavior was present during the Version - Suicidal
assessment period? (Past 3 Months). Behavior (Past 3 Months)
C118070 CSS1121A CSS11-Most Recent Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt Date Version - Most recent attempt date. Version - Most Recent
C118071 CSS1121B CSS11-Most Recent Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt Damage Version - Most recent attempt actual lethality/medical Version - Most Recent
C118072 CSS1121C CSS11-Most Recent Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt Potential Version - Most recent attempt potential lethality. Version - Most Recent
Lethality
C118073 CSS1122A CSS11-Most Lethal Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt Date Version - Most lethal attempt date. Version - Most Lethal
C118074 CSS1122B CSS11-Most Lethal Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt Damage Version - Most lethal attempt actual lethality/medical Version - Most Lethal
C118075 CSS1122C CSS11-Most Lethal Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt Potential Version - Most lethal attempt potential lethality. Version - Most Lethal
Lethality
C118076 CSS1123A CSS11-First Attempt Date Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Version - Initial/first attempt date. Version - First Suicide
Attempt Date
C118077 CSS1123B CSS11-First Attempt Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Damage Version - Initial/first attempt actual lethality/medical Version - First Suicide
C118078 CSS1123C CSS11-First Attempt Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Potential Version - Initial/first attempt potential lethality. Version - First Suicide
Attempt Potential
Lethality
page 304 of 1925

CSS11TN (Columbia-Suicide Severity Rating Scale Lifetime/Recent Version Questionnaire Test Name)
C117988 CSS11TN
Code Value
C118064 CSS11-Aborted Attempt, CSS11-Aborted Attempt, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Describe Describe Version - Description of aborted or self-interrupted Version - Description of
attempt. Aborted Suicide Attempt
C118060 CSS11-Aborted Attempt- CSS11-Aborted Attempt- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Life Version - Has there been a time when you started to do Version - Aborted Suicide
something to try to end your life but you stopped yourself Attempt (Lifetime)
before you actually did anything? (Lifetime).
C118061 CSS11-Aborted Attempt- CSS11-Aborted Attempt- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P3M P3M Version - Has there been a time when you started to do Version - Aborted Suicide
something to try to end your life but you stopped yourself Attempt (Past 3 Months)
before you actually did anything? (Past 3 Months).
C118052 CSS11-Actual Attempt, CSS11-Actual Attempt, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Describe Describe Version - Description of actual attempt. Version - Description of
C118048 CSS11-Actual Attempt- CSS11-Actual Attempt- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Life Version - Have you made a suicide attempt? Have you Version - Actual Suicide
done anything to harm yourself? Have you done anything Attempt (Lifetime)
dangerous where you could have died? (Lifetime).
C118049 CSS11-Actual Attempt- CSS11-Actual Attempt- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P3M P3M Version - Have you made a suicide attempt? Have you Version - Actual Suicide
done anything to harm yourself? Have you done anything Attempt (Past 3 Months)
dangerous where you could have died? (Past 3 Months).
C118077 CSS11-First Attempt CSS11-First Attempt Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Damage Damage Version - Initial/first attempt actual lethality/medical Version - First Suicide
C118076 CSS11-First Attempt Date CSS11-First Attempt Date Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Version - Initial/first attempt date. Version - First Suicide
Attempt Date
C118078 CSS11-First Attempt CSS11-First Attempt Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Potential Potential Version - Initial/first attempt potential lethality. Version - First Suicide
Attempt Potential
Lethality
C118030 CSS11-Idea, Intent, No CSS11-Idea, Intent, No Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Plan, Describe Plan, Describe Version - Description of active suicidal ideation with some Version - Description of
intent to act, without specific plan. Active Suicidal Ideation
Plan-Life Plan-Life Version - Have you had these thoughts and had some Version - Active Suicidal
intention of acting on them? (Lifetime). Ideation with Some
Plan-P1M Plan-P1M Version - Have you had these thoughts and had some Version - Active Suicidal
intention of acting on them? (Past 1 Month). Ideation with Some
Specific Plan (Past 1
Month)
C118027 CSS11-Idea, No Intent, CSS11-Idea, No Intent, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
No Plan, Describe No Plan, Describe Version - Description of active suicidal ideation with any Version - Description of
Act
No Plan-Life No Plan-Life Version - Have you been thinking about how you might Version - Active Suicidal
do this? (Lifetime). Ideation with Any
Methods (Not Plan)
(Lifetime)
page 305 of 1925

C117988 CSS11TN
Code Value
No Plan-P1M No Plan-P1M Version - Have you been thinking about how you might Version - Active Suicidal
do this? (Past 1 Month). Ideation with Any
Methods (Not Plan)
(Past 1 Month)
C118033 CSS11-Idea, Plan, Intent, CSS11-Idea, Plan, Intent, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Describe Describe Version - Description of active suicidal ideation with Version - Description of
Intent
C118031 CSS11-Idea, Plan, Intent- CSS11-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Life Version - Have you started to work out or worked out the Version - Active Suicidal
this plan? (Lifetime). Plan and Intent (Lifetime)
C118032 CSS11-Idea, Plan, Intent- CSS11-Idea, Plan, Intent- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P1M P1M Version - Have you started to work out or worked out the Version - Active Suicidal
this plan? (Past 1 Month). Plan and Intent (Past 1
Month)
C118059 CSS11-Interrupted CSS11-Interrupted Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt, Describe Attempt, Describe Version - Description of interrupted attempt. Version - Description of
Interrupted Suicide
Attempt
Attempt-Life Attempt-Life Version - Has there been a time when you started to do Version - Interrupted
something to end your life but someone or something Suicide Attempt
stopped you before you actually did anything? (Lifetime). (Lifetime)
Attempt-P3M Attempt-P3M Version - Has there been a time when you started to do Version - Interrupted
something to end your life but someone or something Suicide Attempt (Past 3
stopped you before you actually did anything? (Past 3 Months)
Months).
C118074 CSS11-Most Lethal CSS11-Most Lethal Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt Damage Attempt Damage Version - Most lethal attempt actual lethality/medical Version - Most Lethal
Attempt Date Attempt Date Version - Most lethal attempt date. Version - Most Lethal
Attempt Potential Attempt Potential Version - Most lethal attempt potential lethality. Version - Most Lethal
Lethality
C118071 CSS11-Most Recent CSS11-Most Recent Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempt Damage Attempt Damage Version - Most recent attempt actual lethality/medical Version - Most Recent
Attempt Date Attempt Date Version - Most recent attempt date. Version - Most Recent
Attempt Potential Attempt Potential Version - Most recent attempt potential lethality. Version - Most Recent
Lethality
C118042 CSS11-Most Severe Idea, CSS11-Most Severe Idea, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Control-Life Control-Life Version - Could/can you stop thinking about killing Version - Controllability of
yourself or wanting to die if you want to? (Lifetime). Most Severe Ideation
(Lifetime)
Control-P1M Control-P1M Version - Could/can you stop thinking about killing Version - Controllability of
yourself or wanting to die if you want to? (Past 1 Month). Most Severe Ideation
(Past 1 Month)
Desc-Life Desc-Life Version - Description of most severe ideation. (Lifetime). Version - Describe Most
Severe Ideation
(Lifetime)
page 306 of 1925

C117988 CSS11TN
Code Value
Desc-Recent-P1M Desc-Recent-P1M Version - Description of most severe ideation. (Recent - Version - Describe Recent
Past 1 Month). Most Severe Ideation
(Past 1 Month)
Deterrents-Life Deterrents-Life Version - Are there things - anyone or anything (e.g., Version - Deterrents to
wanting to die or acting on thoughts of committing (Lifetime)
suicide? (Lifetime).
Deterrents-P1M Deterrents-P1M Version - Are there things - anyone or anything (e.g., Version - Deterrents to
wanting to die or acting on thoughts of committing (Past 1 Month)
suicide? (Past 1 Month).
Duration-Life Duration-Life Version - When you have the thoughts how long do they Version - Duration of
last? (Lifetime). Most Severe Ideation
(Lifetime)
Duration-P1M Duration-P1M Version - When you have the thoughts how long do they Version - Duration of
last? (Past 1 Month). Most Severe Ideation
(Past 1 Month)
Frequency-Life Frequency-Life Version - How many times have you had these thoughts? Version - Frequency of
(Lifetime)
Frequency-P1M Frequency-P1M Version - How many times have you had these thoughts? Version - Frequency of
(Past 1 Month). Most Severe Ideation
(Past 1 Month)
Reasons-Life Reasons-Life Version - What sort of reasons did you have for thinking Version - Reasons for
pain or stop the way you were feeling (in other words you (Lifetime)
from others? Or both? (Lifetime).
Reasons-P1M Reasons-P1M Version - What sort of reasons did you have for thinking Version - Reasons for
pain or stop the way you were feeling (in other words you (Past 1 Month)
from others? Or both? (Past 1 Month).
C118034 CSS11-Most Severe Idea- CSS11-Most Severe Idea- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Life Version - Most severe ideation. (Lifetime). Version - Most Severe
Ideation (Lifetime)
C118036 CSS11-Most Severe Idea- CSS11-Most Severe Idea- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Recent-P1M Recent-P1M Version - Most severe ideation. (Recent - Past 1 Month). Version - Recent Most
Month)
C118024 CSS11-Non-Spec Suicid CSS11-Non-Spec Suicid Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Thought, Describe Thought, Describe Version - Description of non-specific active suicidal Version - Description of
Suicidal Thoughts
Thought-Life Thought-Life Version - Have you actually had any thoughts of killing Version - Non-Specific
yourself? (Lifetime). Active Suicidal Thoughts
(Lifetime)
Thought-P1M Thought-P1M Version - Have you actually had any thoughts of killing Version - Non-Specific
yourself? (Past 1 Month). Active Suicidal Thoughts
(Past 1 Months)
C118053 CSS11-Non-suicid Self- CSS11-Non-suicid Self- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
injur Behav-Life injur Behav-Life Version - Has subject engaged in non-suicidal self- Version - Non-suicidal
injurious behavior? (Lifetime). Self-injurious Behavior
(Lifetime)
page 307 of 1925

C117988 CSS11TN
Code Value
C118054 CSS11-Non-suicid Self- CSS11-Non-suicid Self- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
injur Behav-P3M injur Behav-P3M Version - Has subject engaged in non-suicidal self- Version - Non-suicidal
injurious behavior? (Past 3 Months). Self-injurious Behavior
(Past 3 Months)
C118057 CSS11-Num of CSS11-Num of Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Interrupted Attempts-Life Interrupted Attempts-Life Version - Total number of interrupted attempts. Version - Number of
(Lifetime). Interrupted Suicide
Attempts (Lifetime)
C118058 CSS11-Num of CSS11-Num of Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Interrupted Attempts- Interrupted Attempts- Version - Total number of interrupted attempts. (Past 3 Version - Number of
P3M P3M Months). Interrupted Suicide
Attempts (Past 3 Months)
C118062 CSS11-Number of CSS11-Number of Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Aborted Attempts-Life Aborted Attempts-Life Version - Total number of aborted or self-interrupted Version - Number of
attempts. (Lifetime). Aborted Suicide Attempts
(Lifetime)
C118063 CSS11-Number of CSS11-Number of Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Aborted Attempts-P3M Aborted Attempts-P3M Version - Total number of aborted or self-interrupted Version - Number of
attempts. (Past 3 Months). Aborted Suicide Attempts
(Past 3 Months)
C118050 CSS11-Number of Actual CSS11-Number of Actual Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempts-Life Attempts-Life Version - Total number of actual attempts. (Lifetime). Version - Number of
(Lifetime)
C118051 CSS11-Number of Actual CSS11-Number of Actual Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Attempts-P3M Attempts-P3M Version - Total number of actual attempts. (Past 3 Version - Number of
Months). Actual Suicide Attempts
(Past 3 Months)
C118067 CSS11-Preparatory CSS11-Preparatory Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Acts/Behavior, Descr Acts/Behavior, Descr Version - Description of preparatory acts or behavior. Version - Description of
Preparatory Acts or
Attempt
Acts/Behavior-Life Acts/Behavior-Life Version - Have you taken any steps towards making a Version - Preparatory
collecting pills, getting a gun, giving valuables away or Suicide Attempt
writing a suicide note)? (Lifetime). (Lifetime)
Acts/Behavior-P3M Acts/Behavior-P3M Version - Have you taken any steps towards making a Version - Preparatory
collecting pills, getting a gun, giving valuables away or Suicide Attempt (Past 3
writing a suicide note)? (Past 3 Months). Months)
C118068 CSS11-Suicidal Behavior- CSS11-Suicidal Behavior- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Life Version - Suicidal behavior was present during the Version - Suicidal
assessment period? (Lifetime). Behavior (Lifetime)
C118069 CSS11-Suicidal Behavior- CSS11-Suicidal Behavior- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P3M P3M Version - Suicidal behavior was present during the Version - Suicidal
assessment period? (Past 3 Months). Behavior (Past 3 Months)
C118021 CSS11-Wish to be Dead, CSS11-Wish to be Dead, Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Describe Describe Version - Description of wishing to be dead. Version - Description of
Wish to be Dead
C118019 CSS11-Wish to be Dead- CSS11-Wish to be Dead- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
Life Life Version - Have you wished you were dead or wished you Version - Wish to be Dead
could go to sleep and not wake up? (Lifetime). (Lifetime)
C118020 CSS11-Wish to be Dead- CSS11-Wish to be Dead- Columbia-Suicide Severity Rating Scale Lifetime/Recent C-SSRS Lifetime/Recent
P1M P1M Version - Have you wished you were dead or wished you Version - Wish to be Dead
could go to sleep and not wake up? (Past 1 Month). (Past 1 Month)
page 308 of 1925

CTTIMIRS (Coronary Thrombus TIMI Grade Responses)
C119017 CTTIMIRS
Code Value
C119583 CORONARY THROMBUS Possible thrombus present - angiography demonstrates TIMI Coronary Thrombus
TIMI GRADE 1 characteristics such as reduced contrast density, Grade 1
haziness, irregular lesion contour or a smooth convex
'meniscus' at the site of total occlusion suggestive but not
diagnostic of thrombus. (Gibson, C. M., de Lemos, J. A.,
Murphy, S. A., Marble, S. J., McCabe, C. H., Cannon, C.
P., Antman, E. M., Braunwald, E. Combination therapy
with abciximab reduces angiographically evident
thrombus in acute myocardial infarction: a TIMI 14
substudy Circulation. 2001;103(21):2550-4.)
C119584 CORONARY THROMBUS Small size definite thrombus, with greatest dimensions TIMI Coronary Thrombus
TIMI GRADE 2 less than or equal to 1/2 vessel diameter. (Gibson, C. M., Grade 2
de Lemos, J. A., Murphy, S. A., Marble, S. J., McCabe, C.
H., Cannon, C. P., Antman, E. M., Braunwald, E.
Combination therapy with abciximab reduces
angiographically evident thrombus in acute myocardial
infarction: a TIMI 14 substudy Circulation.
2001;103(21):2550-4.)
C119585 CORONARY THROMBUS Moderate size definite thrombus, with greatest linear TIMI Coronary Thrombus
TIMI GRADE 3 dimension greater than 1/2 but less than 2 vessel Grade 3
diameters. (Gibson, C. M., de Lemos, J. A., Murphy, S.
A., Marble, S. J., McCabe, C. H., Cannon, C. P., Antman,
E. M., Braunwald, E. Combination therapy with abciximab
reduces angiographically evident thrombus in acute
myocardial infarction: a TIMI 14 substudy Circulation.
2001;103(21):2550-4.)
C119586 CORONARY THROMBUS Large size definite thrombus, with the largest dimension TIMI Coronary Thrombus
TIMI GRADE 4 greater than or equal to 2 vessel diameters. (Gibson, C. Grade 4
M., de Lemos, J. A., Murphy, S. A., Marble, S. J., McCabe,
C. H., Cannon, C. P., Antman, E. M., Braunwald, E.
Combination therapy with abciximab reduces
angiographically evident thrombus in acute myocardial
infarction: a TIMI 14 substudy Circulation.
2001;103(21):2550-4.)
C119587 CORONARY THROMBUS Total vessel occlusion. (Gibson, C. M., de Lemos, J. A., TIMI Coronary Thrombus
TIMI GRADE 5 Murphy, S. A., Marble, S. J., McCabe, C. H., Cannon, C. Grade 5
P., Antman, E. M., Braunwald, E. Combination therapy
with abciximab reduces angiographically evident
thrombus in acute myocardial infarction: a TIMI 14
substudy Circulation. 2001;103(21):2550-4.)
page 309 of 1925

CVFARS (Cardiovascular Findings About Results)
C119016 CVFARS
Code
C20080 ANGIOGRAPHY A method used to create an image of blood Angiography

vessels.
C119199 AUGMENTATION OF ORAL Initiation or intensification of orally administered Oral Diuretic Therapy
DIURETIC THERAPY medication(s) that promote diuresis to treat Augmentation for Heart
heart failure. Failure
C25153 AUTOPSY A postmortem examination of the body. Autopsy
C119200 CLINICALLY SIGNIFICANT OR Weight gain thought to be related to fluid Weight Gain Due to Fluid
RAPID WEIGHT GAIN retention. Retention
C119201 CORONARY LESION ON Angiographic evidence of new or worse greater Coronary Lesion by
ANGIOGRAPHY than or equal to 70 percent lesion and/or Angiographic Finding
thrombus in an epicardial coronary artery
believed to be responsible for the myocardial
ischemic symptoms/signs. (Hicks KA, Tcheng JE,
Bozkurt B, Chaitman BR, Cutlip DE, Farb A,
Fonarow GC, Jacobs JP, Jaff MR, Lichtman JH,
Limacher MC, Mahaffey KW, Mehran, R, Nissen
SE, Smith EE, Targum SL. 2014 ACC/AHA Key
Data Elements and Definitions For
Cardiovascular Endpoint Events In Clinical Trials:
a report of the American College of
Cardiology/American Heart Association Task
Force on Clinical Data Standards (Writing
Committee to Develop Cardiovascular End Points
Data Standards) J Am Coll Cardiol 2014; In
Press)
C119202 CORONARY REVASCULARIZATION Need for coronary revascularization procedure Coronary

(PCI or CABG) for the presumed culprit lesion(s). Revascularization
This criterion would be fulfilled if Procedure
revascularization was undertaken during the
unscheduled hospitalization, or subsequent to
transfer to another institution without
interceding home discharge. (Hicks KA, Tcheng
JE, Bozkurt B, Chaitman BR, Cutlip DE, Farb A,
Press)
C119203 DECREASED EXERCISE Reduced ability to withstand or participate in Decreased Exercise

TOLERANCE activities that induce physical or mental exertion. Tolerance
C2998 DYSPNEA Includes dyspnea on exertion, dyspnea at rest, Dyspnea

orthopnea, and paroxysmal nocturnal dyspnea.
C3036 FATIGUE Unusual tiredness and inability to perform usual Fatigue

activities.
C119204 HEART FAILURE An event where the patient is admitted to the Hospitalization Due to
HOSPITALIZATION hospital with a primary diagnosis of heart failure Heart Failure
(HF), where the length of stay is at least 24
hours (or extends over a calendar date), where
the patient exhibits new or worsening symptoms
of HF on presentation, has objective evidence of
new or worsening HF, and receives initiation or
intensification of treatment specifically for HF.
(Hicks KA, Tcheng JE, Bozkurt B, Chaitman BR,
Cutlip DE, Farb A, Fonarow GC, Jacobs JP, Jaff
MR, Lichtman JH, Limacher MC, Mahaffey KW,
Mehran, R, Nissen SE, Smith EE, Targum SL.
2014 ACC/AHA Key Data Elements and
Definitions For Cardiovascular Endpoint Events
In Clinical Trials: a report of the American
College of Cardiology/American Heart
Association Task Force on Clinical Data
Standards (Writing Committee to Develop
Cardiovascular End Points Data Standards) J Am
Coll Cardiol 2014; In Press)
page 310 of 1925

C119016 CVFARS
Code
C95803 HEMORRHAGIC STROKE An acute episode of focal or global cerebral or Hemorrhagic

spinal dysfunction caused by intraparenchymal, Cerebrovascular Accident
intraventricular, or subarachnoid hemorrhage.
C119205 INCREASE IN HEART FAILURE Biomarker increase (B-type natriuretic peptide Increase in B-type
BIOMARKER (BNP)/ N-terminal pro-BNP (NT-proBNP)) Natriuretic Peptide or N-
consistent with decompensation of heart failure terminal pro-B-type
(such as BNP greater than 500 pg/mL or NT- Natriuretic Peptide
proBNP greater than 2,000 pg/mL). In patients
with chronically elevated natriuretic peptides, a
significant increase above baseline is required.
C119206 INCREASED JUGULAR VENOUS Increase in the estimated height of the mean Increase in Jugular
PRESSURE OR HEPATOJUGULAR jugular venous waveform above the right atrium Venous Pressure
REFLUX in cm.
C2885 INCREASING ABDOMINAL Ascites Abnormal collection of fluid in the peritoneal Ascites
DISTENTION OR ASCITES cavity.
C119207 INDUCIBLE MYOCARDIAL Definite evidence of inducible myocardial Inducible Myocardial

ISCHEMIA ischemia believed to be responsible for the Ischemia
myocardial ischemic symptoms/signs,
demonstrated by any of the following: a) an
early positive exercise stress test, defined as ST
elevation of greater than or equal to 2 mm ST
depression prior to 5 mets, b) stress
echocardiography (reversible wall motion
abnormality), c) myocardial scintigraphy
(reversible perfusion defect), d) MRI (myocardial
perfusion deficit under pharmacologic stress).
C119208 INTRAVENOUS DIURETIC, Initiation or intensification of medication(s) Intravenous Diuretic,

INOTROPE, OR VASODILATOR administered by vein to treat heart failure, to Inotropic or Vasodilator
THERAPY increase the production of urine, increase cardiac Augmentation for Heart
performance, and/or reduce cardiac preload or Failure
afterload.
C119209 INVASIVE DIAGNOSTIC EVIDENCE Invasive diagnostic evidence with right heart Heart Failure by Invasive
OF HEART FAILURE catheterization showing a pulmonary capillary Diagnostic Technique
wedge pressure (pulmonary artery occlusion
pressure) greater than or equal to 18 mmHg,
central venous pressure greater than or equal to
12 mmHg, or a cardiac index less than 2.2
L/min/m2. (Hicks KA, Tcheng JE, Bozkurt B,
Chaitman BR, Cutlip DE, Farb A, Fonarow GC,
Jacobs JP, Jaff MR, Lichtman JH, Limacher MC,
Mahaffey KW, Mehran, R, Nissen SE, Smith EE,
Targum SL. 2014 ACC/AHA Key Data Elements
and Definitions For Cardiovascular Endpoint
Events In Clinical Trials: a report of the
American College of Cardiology/American Heart
C95802 ISCHEMIC STROKE Ischemic stroke is defined as an acute episode of Ischemic Cerebrovascular
focal cerebral, spinal, or retinal dysfunction Accident
caused by infarction of central nervous system
tissue.
page 311 of 1925

C119016 CVFARS
Code
C119210 LOSS OF A SIDE BRANCH Angiographic loss of patency of a side branch. Loss of Patency of Side
Branch
C119211 LOSS OF MAJOR CORONARY Angiographic loss of patency of a major Loss of Patency of Major
epicardial vessel. Vessel
C119212 MECHANICAL OR SURGICAL Mechanical circulatory support (e.g., intra-aortic Vasculature Mechanical or
INTERVENTION balloon pump, ventricular assist device, Surgical Intervention
extracorporeal membrane oxygenation, total
artificial heart) or mechanical fluid removal (e.g.,
ultrafiltration, hemofiltration, dialysis). (Hicks
KA, Tcheng JE, Bozkurt B, Chaitman BR, Cutlip
DE, Farb A, Fonarow GC, Jacobs JP, Jaff MR,
Lichtman JH, Limacher MC, Mahaffey KW,
C119213 NEW LOSS OF VIABLE Non-invasive imaging evidence of a loss of viable New Loss of Viable
MYOCARDIUM myocardium when compared with the most Myocardium by Non-
recent previous non-invasive imaging study. invasive Imaging
Technique
C119214 NEW REGIONAL WALL MOTION Non-invasive imaging evidence of a decrease in New Regional Wall Motion
ABNORMALITY regional wall motion contractility compared with Abnormality by Non-
the most recent previous non-invasive imaging invasive Imaging
study. Technique
C119215 NON-INVASIVE DIAGNOSTIC Non-invasive diagnostic evidence of clinically Heart Failure by Non-
EVIDENCE OF HEART FAILURE significant elevated left- or right-sided invasive Diagnostic
ventricular filling pressure or low cardiac output. Technique
For example, echocardiographic criteria could
include: E/e' greater than 15 or D-dominant
pulmonary venous inflow pattern, plethoric
inferior vena cava with minimal collapse on
inspiration, or decreased left ventricular outflow
tract (LVOT) minute stroke distance (time
velocity integral (TVI)). (Hicks KA, Tcheng JE,
Bozkurt B, Chaitman BR, Cutlip DE, Farb A,
Press)
C78262 PERIPHERAL EDEMA Increased tissue fluid indicated by perceptible Edema Limbs
pitting indentation on lower leg, foot or sacrum
after palpation.
C119216 PULMONARY Abnormal breath sounds caused by the Rales

RALES/CRACKLES/CREPITATIONS accumulation of fluid in the lungs.
C119217 RADIOLOGICAL EVIDENCE OF Imaging findings consistent with increased Pulmonary Congestion by
PULMONARY CONGESTION intravascular blood volume in the lungs. Radiological Technique
C119218 RESTING ECG CHANGES New or worsening ST or T wave changes on Resting ECG Changes
resting ECG (in the absence of confounders, such
as LBBB or LVH), defined as either: a) Transient
ST elevation (duration less than 20 minutes):
new ST elevation at the J point in any two
contiguous leads (other than leads V2-V3) of
greater than or equal to 0.1 mV. In leads V2-V3,
the following cut-points apply: greater than or
equal to 0.2 mV in men greater than or equal to
40 years, greater than or equal to 0.25 mV in
men less than 40 years, and greater than or
equal to 0.15 mV in women, or b) ST depression
and T-wave changes: new horizontal or down-
sloping ST depression greater than or equal to
0.05 mV in two contiguous leads and/or new T
inversion greater than or equal to 0.3 mV in two
contiguous leads with prominent R wave or R/S
ratio greater than 1.
page 312 of 1925

C119016 CVFARS
Code
C61455 S3 GALLOP Presence of mid-diastolic heart sound. S3 Gallop
C119219 SLOW-FLOW/NO- Angiographic reduction of flow into the coronary Flow Reduced in Coronary
FLOW/EMBOLIZATION microcirculation. Microcirculation
C123439 STENT THROMBOSIS ARC ACUTE 0 to 24 hours after stent implantation. (Cutlip Academic Research
DE, Windecker S, Mehran R, et al. Clinical End Council Acute Stent
Points in Coronary Stent Trials : A Case for Thrombosis
Standardized Definitions. Circulation.
2007;115:2344-2351)
C123440 STENT THROMBOSIS ARC LATE Greater than 30 days to 1 year after stent Academic Research
implantation. (Cutlip DE, Windecker S, Mehran Council Late Stent
R, et al. Clinical End Points in Coronary Stent Thrombosis
Trials : A Case for Standardized Definitions.
Circulation. 2007;115:2344-2351)
C123441 STENT THROMBOSIS ARC Greater than 24 hours to 30 days after stent Academic Research
SUBACUTE implantation. (Cutlip DE, Windecker S, Mehran Council Subacute Stent
R, et al. Clinical End Points in Coronary Stent Thrombosis
Trials : A Case for Standardized Definitions.
Circulation. 2007;115:2344-2351)
C123442 STENT THROMBOSIS ARC VERY Greater than 1 year after stent implantation. Academic Research
LATE (Cutlip DE, Windecker S, Mehran R, et al. Clinical Council Very Late Stent
End Points in Coronary Stent Trials : A Case for Thrombosis
Standardized Definitions. Circulation.
2007;115:2344-2351)
C119220 TYPE 1 MYOCARDIAL INFARCTION Spontaneous clinical syndrome related to Joint Task Force Type 1
atherosclerotic plaque rupture, ulceration, Myocardial Infarction
fissuring, erosion, or dissection, with resulting
intraluminal thrombus, and leading to decreased
myocardial blood flow or distal platelet emboli
with ensuing myocyte necrosis. This
classification requires a) detection of a rise
and/or fall of cardiac biomarker values
[preferably cardiac troponin (cTn)] with at least
one value greater than 99th percentile of the
upper reference limit (URL) and b) at least one
of the following: symptoms of myocardial
ischemia; new or presumed new significant ST-
segment-T wave (ST-T) changes or new left
bundle branch block (LBBB) on the ECG;
development of pathological Q waves on the
ECG; imaging evidence of new loss of viable
myocardium or new regional wall motion
abnormality; identification of an intracoronary
thrombus by angiography or autopsy. (Universal
definition of myocardial infarction, Kristian
Thygesen, Joseph S. Alpert and Harvey D. White
on behalf of the Joint ESC/ACCF/AHA/WHF Task
Force for the Redefinition of Myocardial
Infarction, Eur Heart J (2007) 28 (20): 2525-
2538.)
C119221 TYPE 2 MYOCARDIAL INFARCTION Ischemic imbalance: Spontaneous clinical Joint Task Force Type 2
syndrome where a condition other than coronary Myocardial Infarction
artery disease contributes to an imbalance
between myocardial oxygen supply and/or
demand, e.g. coronary endothelial dysfunction,
coronary artery spasm, coronary embolism,
tachy-/brady-arrhythmias, anemia, respiratory
failure, hypotension, and hypertension with or
without left ventricular hypertrophy. This
classification requires detection of a rise and/or
fall of cardiac biomarker values [preferably
cardiac troponin (cTn)] with at least one value
greater than 99th percentile of the upper
reference limit (URL) and b) at least one of the
following: symptoms of myocardial ischemia;
new or presumed new significant ST-segment-T
wave (ST-T) changes or new left bundle branch
block (LBBB) on the ECG; development of
pathological Q waves on the ECG; imaging
evidence of new loss of viable myocardium or
new regional wall motion abnormality. (Universal
2538.)
page 313 of 1925

C119016 CVFARS
Code
C119222 TYPE 3 MYOCARDIAL INFARCTION Death, No Biomarkers: Death where symptoms Joint Task Force Type 3
suggestive of myocardial ischemia are present, Myocardial Infarction
and with (presumed) new ischemic changes or
new LBBB on ECG, but where death occurs
before cardiac biomarkers can be obtained, or
before cardiac biomarker values could rise.
(Universal definition of myocardial infarction,
Kristian Thygesen, Joseph S. Alpert and Harvey
D. White on behalf of the Joint
ESC/ACCF/AHA/WHF Task Force for the
Redefinition of Myocardial Infarction, Eur Heart J
(2007) 28 (20): 2525-2538.)
C119223 TYPE 4A MYOCARDIAL PCI Related: PCI Related Myocardial infarction Joint Task Force Type 4A
INFARCTION associated with and occurring within 48h of Myocardial Infarction
percutaneous coronary intervention, with
elevation of cardiac biomarker values to greater
than 5x 99th percentile of the upper reference
limit (URL) in patients with normal baseline
values (less than or equal to 99th percentile
URL), or a rise of cardiac biomarker values
greater than or equal to 20% if the baseline
values are elevated and are stable or falling. This
classification also requires at least one of the
following: symptoms of myocardial ischemia;
new ischemic ECG changes or new LBBB;
angiographic loss of patency of a major coronary
artery or a side branch or persistent slow- or no-
flow or embolization; imaging evidence of new
loss of viable myocardium or new regional wall
motion abnormality. (Universal definition of
myocardial infarction, Kristian Thygesen, Joseph
S. Alpert and Harvey D. White on behalf of the
Joint ESC/ACCF/AHA/WHF Task Force for the
(2007) 28 (20): 2525-2538.)
C119224 TYPE 4B MYOCARDIAL Stent Thrombosis: Myocardial infarction Joint Task Force Type 4B
INFARCTION associated with stent thrombosis as detected by Myocardial Infarction
coronary angiography or at autopsy, where
symptoms suggestive of myocardial ischemia are
present, and with a rise and/or fall of cardiac
biomarkers values, with at least one value
greater than 99th percentile of the upper
reference limit. (Universal definition of
myocardial infarction, Kristian Thygesen, Joseph
S. Alpert and Harvey D. White on behalf of the
Joint ESC/ACCF/AHA/WHF Task Force for the
(2007) 28 (20): 2525-2538.)
C119225 TYPE 4C MYOCARDIAL Stent Restenosis: Myocardial infarction Joint Task Force Type 4C
INFARCTION associated with stent restenosis as detected by Myocardial Infarction
coronary angiography or at autopsy, occurring
more than 48h after percutaneous coronary
intervention, without evidence of stent
thrombosis but with symptoms suggestive of
myocardial ischemia, and with elevation of
cardiac biomarker values to greater than 99th
percentile of the upper reference limit (URL).
This classification also requires the following:
does not meet criteria for any other classification
of myocardial infarction; presence of a greater
than or equal to 50 percent stenosis at the site
of previous successful stent PCI. (Universal
2538.)
page 314 of 1925

C119016 CVFARS
Code
C119226 TYPE 5 MYOCARDIAL INFARCTION CABG Related: Myocardial infarction associated Joint Task Force Type 5
with and occurring within 48h of coronary artery Myocardial Infarction
bypass graft surgery, with elevation of cardiac
biomarker values to greater than 10x 99th
percentile of the upper reference limit (URL) in
patients with normal baseline cardiac biomarker
values (less than or equal to 99th percentile
URL). This classification also requires at least
one of the following: new pathologic Q waves or
new LBBB on ECG; angiographic new graft or
new native coronary artery occlusion; imaging
evidence of new loss of viable myocardium or
new regional wall motion abnormality. (Universal
2538.)
C3390 UNDETERMINED STROKE An acute episode of focal or global neurological Cerebrovascular Accident
dysfunction caused by presumed brain, spinal
cord, or retinal vascular injury as a result of
hemorrhage or infarction but with insufficient
information to allow categorization as ischemic
or hemorrhagic.
C119227 URGENT HEART FAILURE VISIT An event where the patient has an urgent, ER or Office Visit Due to
unscheduled office/practice or emergency Heart Failure
department visit for a primary diagnosis of heart
failure (HF) but is not admitted to the hospital,
where the patient exhibits new or worsening
symptoms of HF on presentation, has objective
evidence of new or worsening HF, and receives
initiation or intensification of treatment
specifically for HF, with the exception that
changes to oral diuretic therapy do no qualify as
initiation or intensification of treatment. (Hicks
KA, Tcheng JE, Bozkurt B, Chaitman BR, Cutlip
DE, Farb A, Fonarow GC, Jacobs JP, Jaff MR,
Lichtman JH, Limacher MC, Mahaffey KW,
C50591 VOLUME OVERLOAD Excessive accumulation of intravascular fluid Hypervolemia

resulting from compromised regulatory
mechanisms.
C119228 WORSENED END-ORGAN Decreased blood supply to the vital organs Worsened End-Organ
PERFUSION (kidney, liver, lungs, heart, brain). Perfusion
page 315 of 1925

CVFATS (Cardiovascular Findings About Test Name)
C119014 CVFATS
Code Value
C118936 Acute Myocardial Acute Myocardial Categorization of the type of acute myocardial infarction. Acute Myocardial
Infarction Type Infarction Type Infarction Type
C119229 Coronary Artery Coronary Artery The method by which the coronary artery thrombosis Coronary Artery
Thrombosis Method Ident Thrombosis Method Ident event is determined or diagnosed. Thrombosis Method of
Identification
C119230 Endpoint Event Indicator Endpoint Event Indicator An indication as to whether the event meets the criteria Endpoint Event Indicator
for being a clinical endpoint.
C119237 Exclusion of Type 1 and Exclusion of Type 1 and An indication of whether a Type 1 and Type 2 myocardial Exclusion of Type 1 and
Type 2 MI Type 2 MI infarction is excluded as a diagnosis. Type 2 Myocardial
Infarction Diagnosis
Indicator
C119231 Healthcare Encounter Healthcare Encounter Categorization of the type of healthcare encounter. Healthcare Encounter
Type Type Type
C119232 Heart Failure Heart Failure Categorization of the type(s) of new and/or worsening Lab Findings of New or
New/Worsening Lab New/Worsening Lab laboratory findings of heart failure present at the time of Worsening Heart Failure
Findings Findings patient presentation.
C119233 Heart Failure Heart Failure Categorization of the type(s) of new and/or worsening Physical Examination
New/Worsening PE New/Worsening PE physical exam findings of heart failure present at the time Findings of New or
Findings Findings of patient presentation. Worsening Heart Failure
C119234 Heart Failure Therapy, Heart Failure Therapy, Categorization of the type(s) of new and/or intensified Heart Failure Therapy
Intensification Intensification treatment administered for heart failure management. Intensification Type
C119235 Ischemic Discomfort Ischemic Discomfort An indicator as to whether the subject has symptoms of Ischemic Discomfort
Indicator Indicator ischemic discomfort. Indicator
C119236 Ischemic Evidence Type Ischemic Evidence Type Categorization of the type of objective evidence of new or Ischemic Evidence Type
worsening ischemia.
C119238 New or Worsening New or Worsening A description of the new or worsening symptoms related New or Worsening
Symptoms Symptoms to a clinical event. Symptom
C123443 Non-Invasive Imaging Non-Invasive Imaging A description of the clinical change to the subject after a Clinical Change by Non-
Change Change non-invasive imaging procedure. Invasive Imaging
Procedure
C119239 PCI Acute Angiographic PCI Acute Angiographic Categorization of the type of acute PCI angiographic Acute Myocardial
Complication Complication complication resulting in acute myocardial ischemia. Infarction From PCI
Complication Type
C119240 Procedure Success Procedure Success An indication as to whether the procedure is considered Procedure Success
Indicator Indicator successful. Indicator
C101230 Procedure Urgency Status Procedure Urgency Status The degree of urgency in which a medical procedure must Triage Status
Type Type be performed.
C123424 Stent Thrombosis, Stent Thrombosis, Categorization of the timing of coronary stent thrombosis Academic Research
Coronary, ARC Timing Coronary, ARC Timing occurrence per the classification schema described by the Council Coronary Stent
Academic Research Consortium (ARC). Thrombosis Timing
C119579 Stroke Type Stroke Type Categorization of the type of stroke. Stroke Type
C119241 Symptom Indicator Symptom Indicator An indication as to whether the subject had symptoms Symptom Indicator
related to the clinical event.
C119242 Symptom Onset Date Symptom Onset Date The date time of the onset of symptoms of the clinical Symptom Onset Date
event.
C119243 Vessel Occlusion After Vessel Occlusion After An indication as to whether vessel occlusion, in the native Vessel Occlusion 48
CABG 48 Ind CABG 48 Ind or bypass graft, occurred within 48 hours after the Hours after CABG
coronary artery bypass graft procedure. Indicator
page 316 of 1925

CVFATSCD (Cardiovascular Findings About Test Code)
C119015 CVFATSCD
Code Value
C118936 ACMITYPE Acute Myocardial Categorization of the type of acute myocardial infarction. Acute Myocardial
Infarction Type Infarction Type
C119229 CATMTHID Coronary Artery The method by which the coronary artery thrombosis Coronary Artery
Thrombosis Method Ident event is determined or diagnosed. Thrombosis Method of
Identification
C119230 ENDPTIND Endpoint Event Indicator An indication as to whether the event meets the criteria Endpoint Event Indicator
for being a clinical endpoint.
C119231 HETYPE Healthcare Encounter Categorization of the type of healthcare encounter. Healthcare Encounter
Type Type
C119232 HFLBFNW Heart Failure Categorization of the type(s) of new and/or worsening Lab Findings of New or
New/Worsening Lab laboratory findings of heart failure present at the time of Worsening Heart Failure
Findings patient presentation.
C119233 HFPEFNW Heart Failure Categorization of the type(s) of new and/or worsening Physical Examination
New/Worsening PE physical exam findings of heart failure present at the time Findings of New or
Findings of patient presentation. Worsening Heart Failure
C119234 HFTHERIN Heart Failure Therapy, Categorization of the type(s) of new and/or intensified Heart Failure Therapy
Intensification treatment administered for heart failure management. Intensification Type
C119235 ISCDIND Ischemic Discomfort An indicator as to whether the subject has symptoms of Ischemic Discomfort
Indicator ischemic discomfort. Indicator
C119236 ISCETYP Ischemic Evidence Type Categorization of the type of objective evidence of new or Ischemic Evidence Type
worsening ischemia.
C119237 MI12EXC Exclusion of Type 1 and An indication of whether a Type 1 and Type 2 myocardial Exclusion of Type 1 and
Type 2 MI infarction is excluded as a diagnosis. Type 2 Myocardial
Infarction Diagnosis
Indicator
C123443 NINVIMGC Non-Invasive Imaging A description of the clinical change to the subject after a Clinical Change by Non-
Change non-invasive imaging procedure. Invasive Imaging
Procedure
C119238 NWSYMP New or Worsening A description of the new or worsening symptoms related New or Worsening
Symptoms to a clinical event. Symptom
C119239 PCIAAC PCI Acute Angiographic Categorization of the type of acute PCI angiographic Acute Myocardial
Complication complication resulting in acute myocardial ischemia. Infarction From PCI
Complication Type
C119240 PRSUCIND Procedure Success An indication as to whether the procedure is considered Procedure Success
Indicator successful. Indicator
C101230 PRUSTAT Procedure Urgency Status The degree of urgency in which a medical procedure must Triage Status
Type be performed.
C123424 STCTIMNG Stent Thrombosis, Categorization of the timing of coronary stent thrombosis Academic Research
Coronary, ARC Timing occurrence per the classification schema described by the Council Coronary Stent
Academic Research Consortium (ARC). Thrombosis Timing
C119579 STROKTYP Stroke Type Categorization of the type of stroke. Stroke Type
C119241 SYMPINDC Symptom Indicator An indication as to whether the subject had symptoms Symptom Indicator
related to the clinical event.
C119242 SYMSTDTC Symptom Onset Date The date time of the onset of symptoms of the clinical Symptom Onset Date
event.
C119243 VOC48IND Vessel Occlusion After An indication as to whether vessel occlusion, in the native Vessel Occlusion 48
CABG 48 Ind or bypass graft, occurred within 48 hours after the Hours after CABG
coronary artery bypass graft procedure. Indicator
page 317 of 1925

CVPRCIND (Cardiac Procedure Indication)
C101859 CVPRCIND
Code Value
C99919 CANDIDATE TO RECEIVE The intended recipient of a heart transplant. Candidate to Receive
CARDIAC TRANSPLANT Cardiac Transplant
C100033 CARDIAC An episode of cardiac arrest or arrhythmia where the Cardiac

ARREST/ARRHYTHMIA etiology was unknown. Arrest/Arrhythmia
ETIOLOGY UNKNOWN Etiology Unknown
C34830 CARDIOMYOPATHY A disease of the heart muscle or myocardium proper. Cardiomyopathy

Cardiomyopathies may be classified as either primary or
secondary, on the basis of etiology, or on the
pathophysiology of the lesion: hypertrophic, dilated, or
restrictive.
C99938 CHRONIC TOTAL A longstanding, complete blockage of a vessel. Chronic Total Occlusion
OCCLUSION Vessel
C99947 DONOR FOR CARDIAC The subject contributing a heart for a cardiac transplant. Donor for Cardiac
TRANSPLANT Transplant
C99949 END OF EXPECTED The battery that supplies the device has reached the end End of Expected Battery
BATTERY LIFE of its life. Life
C100035 FAULTY There is a faulty connector/header in the device. Faulty Device

CONNECTOR/HEADER Connector/Header
C99925 GENERATOR IS BEING A cardiac lead requires revision, at which time the Cardiac Device Generator
REPLACED AT THE TIME generator to the device will be replaced. is Being Replaced at Time
OF LEAD REVISION of Lead Revision
C99943 GENERATOR The device has a generator malfunction. Device Generator

MALFUNCTION Malfunction
C99961 IMMEDIATE An immediate percutaneous coronary intervention is Immediate Percutaneous

PERCUTANEOUS necessary for a myocardial infarction that presents with Coronary Intervention for
CORONARY ST segment elevation. ST Elevation Myocardial
INTERVENTION (PCI) FOR Infarction
ST ELEVATION
MYOCARDIAL
INFARCTION (STEMI)
C26726 INFECTION A disorder resulting from the presence and activity of a Infectious Disorder
microbial, viral, or parasitic agent. It can be transmitted
by direct or indirect contact. (NCI)
C99931 LEAD EROSION A cardiac lead has damaged local tissue enough to Cardiac Lead Erosion
require treatment.
C64251 LEFT VENTRICULAR The degree of impairment of the left cardiac ventricle to Left Ventricular Systolic
SYSTOLIC DYSFUNCTION contract efficiently. Dysfunction
C100045 MANUFACTURER RECALL An imperative issued by the manufacturer of a device Manufacturer Recall
that the device needs to be returned to a designated
source for repair or replacement.
C99980 MANUFACTURER The device manufacturer had recognized a recurrent Manufacturer Recognized
RECOGNIZED A performance failure in the device. a Recurring Performance
RECURRING Failure
PERFORMANCE FAILURE
C99982 MEDICAL CONDITION OR The medical condition or the procedure affects the device Medical Condition or
PROCEDURE AFFECTS implantation site. Procedure Affects
IMPLANTATION SITE Implantation Site
C99983 MEDICAL OR SURGICAL An intended medical or surgical procedure necessitates Medical or Surgical
PROCEDURE REQUIRING the relocation of a cardiac lead. Procedure Requiring
RELOCATION OF LEAD Relocation of Lead
page 318 of 1925

C101859 CVPRCIND
Code Value
C99999 PERCUTANEOUS Includes patients with unstable angina or Non-STEMI who Percutaneous Coronary
CORONARY have high risk features for short-term risk of death or Intervention for High Risk
INTERVENTION (PCI) FOR nonfatal MI. High risk features includes at least one of the Non-ST Elevation
HIGH RISK NON-ST following: history of accelerating tempo of ischemic Myocardial Infarction or
ELEVATION MYOCARDIAL symptoms in preceding 48 hours; character of pain - Unstable Angina
INFARCTION OR prolonged ongoing (greater than 20 minutes) rest pain;
UNSTABLE ANGINA clinical findings - pulmonary edema, most likely due to
ischemia or new or worsening mitral regurgitation
murmur; or S3 or new worsening rales or Hypotension,
bradycardia, tachycardia or age greater than 75 years;
ECG - angina at rest with transient ST-segment changes
greater than 0.5 mm or bundle-branch block, new or
presumed new or sustained ventricular tachycardia;
cardiac markers - NSTEMI patients with elevated cardiac
TnT, Tnl, or CK-MB.
C100001 PERCUTANEOUS A percutaneous coronary intervention is necessary for a Percutaneous Coronary

CORONARY myocardial infarction that presents with ST segment Intervention for ST
INTERVENTION (PCI) FOR elevation and the subject does not have recurrent or Elevation Myocardial
ST ELEVATION persistent symptoms, symptoms of heart failure or Infarction-Stable After
MYOCARDIAL ventricular arrhythmia after a successful dose of Successful Full-Dose
INFARCTION (STEMI) thrombolytic therapy. Thrombolytic Therapy
(STABLE AFTER
SUCCESSFUL FULL-DOSE
THROMBOLYTICS)

INTERVENTION (PCI) FOR elevation and the subject does not have recurrent or Elevation Myocardial
ST ELEVATION persistent symptoms, symptoms of heart failure or Infarction-Stable-Over 12
MYOCARDIAL ventricular arrhythmia. The presentation is past twelve Hours From Symptom
INFARCTION (STEMI) hours since onset of symptoms. Onset
(STABLE, >12 HRS FROM
SYMPTOM ONSET)

INTERVENTION (PCI) FOR elevation and the subject has recurrent or persistent Elevation Myocardial
ST ELEVATION symptoms, symptoms of heart failure or ventricular Infarction-Unstable-Over
MYOCARDIAL arrhythmia. The presentation is past twelve hours since 12 Hours From Symptom
INFARCTION (STEMI) onset of symptoms. Onset
(UNSTABLE, >12 HRS
FROM SYMPTOM ONSET)
C100005 POST-CARDIAC A procedure to evaluate the health of the an individual Post-Cardiac Transplant
TRANSPLANT after receiving a heart transplant. Evaluation
C100006 PRE-OPERATIVE A procedure to evaluate the health of the cardiac system Pre-Operative Evaluation
EVALUATION FOR NON- to determine feasibility of a non-cardiac related surgical for Non-Cardiovascular
CARDIOVASCULAR procedure. Surgery
SURGERY
C15306 PRIMARY PREVENTION A procedure performed to avoid the first occurrence of a Primary Prevention
disease condition.
C100008 RESCUE PERCUTANEOUS A percutaneous coronary intervention is imperative for a Rescue Percutaneous
CORONARY myocardial infarction that presents with ST segment Coronary Intervention for
INTERVENTION (PCI) FOR elevation after an unsatisfactory response to a full dose of ST Elevation Myocardial
ST ELEVATION thrombolytic therapy. Infarction After Failed
MYOCARDIAL Full-Dose Thrombolytic
INFARCTION (STEMI) Therapy
(AFTER FAILED FULL-
DOSE THROMBOLYTICS)
C15712 SECONDARY A procedure performed to avoid a subsequent occurrence Secondary Prevention

PREVENTION of a disease condition.
C100014 SPONTANEOUS Ventricular tachycardia that occurs without provocation Spontaneous Sustained
SUSTAINED and does not resolve spontaneously. Ventricular Tachycardia
VENTRICULAR by ECG Finding
TACHYCARDIA
C100015 STAGED PERCUTANEOUS A subsequent Percutaneous Coronary Intervention in a Staged Percutaneous

CORONARY planned series of procedures, where the first PCI could Coronary Intervention
INTERVENTION (PCI) have been during a prior admission, or during this
admission.
C100018 SYNCOPE WITH HIGH A sudden loss of consciousness with loss of postural tone Syncope with High Risk
RISK CHARACTERISTICS not related to anesthesia with high risk characteristics. Cardiac Characteristics
High risk characteristics include non-ischemic dilated
cardiomyopathy, or ischemic heart disease with
significant ventricular dysfunction, hypertrophic
cardiomyopathy, Brugada Syndrome, or Long QT
Syndrome.
page 319 of 1925

C101859 CVPRCIND
Code Value
C100019 SYNCOPE WITH Sudden loss of consciousness with loss of postural tone Syncope with Inducible
INDUCIBLE VENTRICULAR not related to anesthesia with ventricular tachycardia Ventricular Tachycardia
TACHYCARDIA (VT) that can be induced during an electrophysiological by ECG Finding
study.
C100030 UPGRADE TO A DEVICE A device with additional pacing capabilities is replacing Upgrade to Cardiac
WITH ADDITIONAL the current device. Device with Additional
PACING CAPABILITIES Pacing Capabilities
C50799 VENTRICULAR Ventricular Fibrillation is characterized by rapid, usually Ventricular Fibrillation

FIBRILLATION more than 300 bpm (cycle length: 180 ms or less),
grossly irregular ventricular rhythm with marked
variability in QRS cycle length, morphology, and
amplitude.
page 320 of 1925

CVSLDEXT (Coronary Vessel Disease Extent)
C101850 CVSLDEXT
Code Value
C48658 INDETERMINATE Inconclusive Cannot distinguish between two or more possible values Indeterminate
in the current context. (NCI)
C119244 INSIGNIFICANT DISEASE A finding of stenosis of less than 70 percent reduction in Insignificant Disease by
diameter (or 50 percent reduction in cross-sectional area) ECG Finding
in a major epicardial vessel, without stenosis of greater
than or equal to 70 percent reduction in diameter (or 50
percent reduction in cross-sectional area) in any major
epicardial vessel. (NCI)
C99993 NO DISEASE There was no stenosis in any coronary artery or branch No Evidence of Coronary
vessel. Artery Disease
C99997 ONE VESSEL DISEASE There was stenosis of greater than or equal to 70 percent One Vessel Coronary
reduction in diameter (or 50 percent reduction in cross- Disease
sectional area) in one major epicardial vessel or its major
branches.
C100020 THREE VESSEL DISEASE There was one of the following: Stenosis of greater than Three Vessel Coronary
or equal to 70 percent reduction in diameter (or 50 Disease
percent reduction in cross-sectional area) in all three
major epicardial vessels (anterior descending, posterior
descending, circumflex) or their major branches; Stenosis
of greater than or equal to 50 percent reduction in
diameter of the left main and greater than or equal to 70
percent reduction in diameter, or 50 percent reduction in
cross-sectional area of the right coronary artery with a
right dominant or co-dominant circulation; Stenosis of
greater than or equal to 50 percent reduction in diameter
of the left main with a left dominant circulation.
C100023 TWO VESSEL DISEASE There was one of the following: Stenosis of greater than Two Vessel Coronary
or equal to 70 percent reduction in diameter (or 50 Disease
percent reduction in cross-sectional area) in two major
epicardial vessels or their major branches; Stenosis of
greater than or equal to 50 percent reduction in diameter
of the left main with a right dominant or co-dominant
circulation, and no stenosis of greater than or equal to 70
percent reduction in diameter, or 50 percent reduction in
cross-sectional area in the right coronary artery.
page 321 of 1925

CVTEST (Cardiovascular Test Name)
C101846 CVTEST
Code Value
C139038 Aneurysm Indicator Aneurysm Indicator An indication as to whether there is the presence of one Aneurysm Indicator
or more aneurysms.
C127535 Annular a' Velocity Annular a' Velocity The peak velocity of the annular motion during late Annular a' Velocity
ventricular diastole (the active filling of the ventricle).
C127536 Annular e' Velocity Annular e' Velocity The peak velocity of the annular motion during early Annular e' Velocity
ventricular diastole (the passive filling of the ventricle).
C139042 Annular Plane Systolic Annular Plane Systolic The longitudinal displacement of a cardiac valve annulus Annular Plane Systolic
Excursion Excursion toward the apex of the heart. Excursion
C139045 Annular S' Velocity Annular S' Velocity The peak velocity of the annular motion during ventricular Annular S' Velocity
systole.
C122038 Aortic Augmentation Aortic Augmentation The augmentation pressure divided by the aortic pulse Aortic Augmentation
Index Index pressure (aortic systolic minus aortic diastolic pressure) Index
multiplied by 100, expressed as a percentage.
C122083 Aortic Augmentation Aortic Augmentation The aortic augmentation index normalized to a heart rate Aortic Augmentation
Index at 75bpm Index at 75bpm of 75 beats per minute. Index at 75bpm
C122084 Aortic Augmentation Aortic Augmentation The difference between the second pressure peak in the Aortic Augmentation
Pressure Pressure aortic wave, secondary to the pressure wave reflection Pressure
from the sites of peripheral arterial impedance mismatch
(P2) and the first pressure peak in the aortic wave form,
secondary to ventricular ejection (P1).
C122085 Aortic Augmentation Aortic Augmentation The first pressure peak in the aortic wave form secondary Augmentation Pressure
Pressure Peak P1 Pressure Peak P1 to ventricular ejection. Point P1
C122086 Aortic Augmentation Aortic Augmentation The second pressure peak in the aortic waveform Augmentation Pressure
Pressure Peak P2 Pressure Peak P2 secondary to pressure wave reflection from the periphery. Point P2
C139033 Aortic Coarctation Aortic Coarctation An indication as to whether there is coarctation of the Aortic Coarctation
Indicator Indicator aorta. Indicator
C139037 Aortic Coarctation Aortic Coarctation The assessment of the severity of aortic coarctation. Aortic Coarctation
Severity Severity Severity
C139035 Aortic Ductal Coarctation Aortic Ductal Coarctation The assessment of the severity of ductal aortic Aortic Juxta-ductal
Severity Severity;Aortic Juxta- coarctation. Coarctation Severity
ductal Coarctation
Severity
C139036 Aortic Postductal Aortic Postductal The assessment of the severity of postductal aortic Aortic Postductal
Coarctation Severity Coarctation Severity coarctation. Coarctation Severity
C139034 Aortic Preductal Aortic Preductal The assessment of the severity of preductal aortic Aortic Preductal
Coarctation Severity Coarctation Severity coarctation. Coarctation Severity
C127539 Aortic Regur Jet Width Aortic Regur Jet Width A relative measurement (ratio) of the aortic regurgitant Aortic Regurgitant Jet
LVOT Diam Rt LVOT Diam Rt;Aortic jet width to left ventricular outflow tract (LVOT) diameter. Width to Left Ventricular
Regurgitant Jet Width to Outflow Tract Diameter
Left Ventricular Outflow Ratio
Tract Diameter Ratio
C127540 Aortic Valve Regurgitant Aortic Valve Regurgitant A measurement of the volume of retrograde blood flow Aortic Valve Regurgitant
Fraction Fraction across the orifice of the aortic valve expressed as a Fraction
percentage of the anterograde flow volume.
C127541 Aortic Valve Regurgitant Aortic Valve Regurgitant The measured width of the regurgitant jet of blood into Aortic Valve Regurgitant
Jet Width Jet Width the left ventricular outflow tract. Jet Width
C127542 Aortic Valve Regurgitant Aortic Valve Regurgitant A measurement of the volume of retrograde blood flow Aortic Valve Regurgitant
Volume Volume across the orifice of the aortic valve. Volume
C127543 Aortic Valve Vena Aortic Valve Vena The area of the vena contracta of the aortic valve. Aortic Valve Vena
Contracta Area Contracta Area Contracta Area
C127544 Aortic Valve Vena Aortic Valve Vena The width of the vena contracta of the aortic valve. Aortic Valve Vena
Contracta Width Contracta Width Contracta Width
C127537 Area, End Ventricular Area, End Ventricular The 2-dimensional surface enclosed within a boundary of Area at End Ventricular
Diastole Diastole a cardiovascular structure and measured at end Diastole
ventricular diastole.
page 322 of 1925

C101846 CVTEST
Code Value
C127538 Area, End Ventricular Area, End Ventricular The 2-dimensional surface enclosed within a boundary of Area at End Ventricular
Systole Systole a cardiovascular structure and measured at end Systole
ventricular systole.
C94866 Blood Flow Rate Blood Flow Rate The volume of blood per unit time passing through a Blood Flow Rate
specified location, such as a point in a blood vessel or an
entire organ.
C119245 Cardiac Index Cardiac Index The measure of an individual's cardiac output divided by Cardiac Index
the individual's body surface area (CI= CO/BSA).
C139063 Cardiac Muscle Cardiac Muscle An indication as to whether there is a hypertrophied Heart Chamber
Hypertrophy Indicator Hypertrophy Indicator cardiac muscle. Hypertrophy Indicator
C119246 Cardiac Output Cardiac Output The total volume of blood pumped by the heart over a set Cardiac Output
period of time, conventionally one minute; it is calculated
as heart rate times stroke volume (CO= HR x SV).
C127563 Cardiac Valve Regur Jet Cardiac Valve Regur Jet The trajectory of the retrograde blood flow from a cardiac Cardiac Valve Regurgitant
Direction Direction;Cardiac Valve valve. Jet Direction
Regurgitation Jet
Direction
C142245 Cardiac Valve Stenosis Cardiac Valve Stenosis A description of the likely cause of the pathology Cardiac Valve Stenosis
Likely Etiology Likely Etiology responsible for the cardiac valve stenosis. Likely Etiology
C139056 Cardiac Valvular Regur Cardiac Valvular Regur An estimation as to the cause of the pathology Cardiac Valvular
Likely Etiology Likely Etiology;Cardiac responsible for the cardiac valve regurgitation. Regurgitation Likely
Valvular Regurgitation Etiology
Likely Etiology
C139055 Cardiac Valvular Cardiac Valvular An indication as to whether a specific cardiac valve is Cardiac Valvular
Regurgitation Indicator Regurgitation Indicator regurgitant. Regurgitation Indicator
C102244 Cardiac Valvular Cardiac Valvular The qualitative measurement of the severity of cardiac Cardiac Valvular
Regurgitation Severity Regurgitation Severity valvular regurgitation. Regurgitation Severity
C142244 Cardiac Valvular Stenosis Cardiac Valvular Stenosis An indication as to whether the cardiac valve in question Cardiac Valvular Stenosis
Indicator Indicator has stenosis. Indicator
C102245 Cardiac Valvular Stenosis Cardiac Valvular Stenosis The qualitative measurement of the severity of cardiac Cardiac Valvular Stenosis
Severity Severity valvular stenosis. Severity
C127564 Cardiac Wall Motion Type Cardiac Wall Motion Type The assessment of the movement of the cardiac muscle, Cardiac Wall Motion Type
either as a whole or at one or more specific anatomical
locations.
C127562 Chordae Tendineae Chordae Tendineae An indication as to whether there is prolapsing of a Chordae Tendineae
Prolapse Indicator Prolapse Indicator cardiac valve chordae tendinae. Prolapse Indicator
C100086 Coronary Artery Coronary Artery The pattern of the epicardial vessels supplying the Coronary Artery
Dominance Dominance posterolateral and posterior descending coronary arteries. Dominance
C119331 Coronary Artery No Coronary Artery No An indication as to whether there is a new acute Coronary No Reflow at
Reflow Indicator Reflow Indicator reduction in coronary flow (TIMI grade 0-1) in the PCI Site Indicator
absence of dissection, thrombus, spasm, or high-grade
residual stenosis at the original PCI lesion site.
C127545 Cross-sec Diameter, EVD Cross-sec Diameter, The cross sectional diameter of a cardiovascular structure Cross-sectional Diameter
EVD;Cross-sectional measured at end ventricular diastole. at End Ventricular
Diameter, End Ventricular Diastole
Diastole
C127546 Cross-sec Diameter, EVS Cross-sec Diameter, The cross sectional diameter of a cardiovascular structure Cross-sectional Diameter
EVS;Cross-sectional measured at end ventricular systole. at End Ventricular Systole
Diameter, End Ventricular
Systole
C127547 Cross-sec Diameter, MVS Cross-sec Diameter, The cross sectional diameter of a cardiovascular structure Cross-sectional Diameter
MVS;Cross-sectional measured at mid ventricular systole. at Mid Ventricular Systole
Diameter, Mid Ventricular
Systole
C127595 Cross-sec Thickness, EVD Cross-sec Thickness, The cross-sectional thickness of a cardiovascular Cross-sectional Thickness
EVD;Cross-sectional structure measured at end ventricular diastole. at End Ventricular
Thickness, End Diastole
Ventricular Diastole
C127596 Cross-sec Thickness, EVS Cross-sec Thickness, The cross-sectional thickness of a cardiovascular Cross-sectional Thickness
EVS;Cross-sectional structure measured at end ventricular systole. at End Ventricular Systole
Thickness, End
Ventricular Systole
page 323 of 1925

C101846 CVTEST
Code Value
C139032 Cross-sectional Diameter Cross-sectional Diameter A measurement of a structure taken along the plane that Cross-sectional Diameter
is perpendicular to the long axis.
C127548 Cusp Doming Indicator Cusp Doming Indicator An indication as to whether there is doming of a cardiac Cusp Doming Indicator
valve cusp.
C127549 Cusp Doming Severity Cusp Doming Severity The assessment of the severity of doming of a cardiac Cusp Doming Severity
valve cusp.
C127550 Cusp Flail Indicator Cusp Flail Indicator An indication as to whether there is a flailing cardiac Cusp Flail Indicator
valve cusp.
C127551 Cusp Flail Severity Cusp Flail Severity The assessment of the severity of a flailing cardiac valve Cusp Flail Severity
cusp.
C127552 Cusp Flail Timing Cusp Flail Timing The time point during the cardiac cycle when the flail of Cusp Flail Timing
one or more cardiac valve cusps occurs.
C127553 Cusp Prolapse Indicator Cusp Prolapse Indicator An indication as to whether there is a prolapsing cardiac Cusp Prolapse Indicator
valve cusp.
C127554 Cusp Prolapse Severity Cusp Prolapse Severity The assessment of the severity of a prolapsing cardiac Cusp Prolapse Severity
valve cusp.
C127555 Cusp Prolapse Timing Cusp Prolapse Timing The time point during the cardiac cycle when the prolapse Cusp Prolapse Timing
of one or more cardiac valve cusps occurs.
C127556 Cusp Restricted Motion Cusp Restricted Motion An indication as to whether there is restricted motion of a Cusp Restricted Motion
Indicator Indicator cardiac valve cusp. Indicator
C127557 Cusp Restricted Motion Cusp Restricted Motion The assessment of the severity of restricted motion of a Cusp Restricted Motion
Severity Severity cardiac valve cusp. Severity
C127558 Cusp Tethering Indicator Cusp Tethering Indicator An indication as to whether there is tethering of a cardiac Cusp Tethering Indicator
valve cusp.
C127559 Cusp Tethering Severity Cusp Tethering Severity The assessment of the severity of tethering of a cardiac Cusp Tethering Severity
valve cusp.
C127560 Cusp Thickening Indicator Cusp Thickening Indicator An indication as to whether there is a thickened cardiac Cusp Thickening Indicator
valve cusp.
C127561 Cusp Thickening Severity Cusp Thickening Severity The assessment of the severity of a thickening cardiac Cusp Thickening Severity
cusp.
C139041 DeBakey AoD DeBakey AoD The type of aortic dissection present as defined by the DeBakey Aortic Dissection
Classification Classification;DeBakey DeBakey Classification System (DeBakey ME, Henly WS, Classification
Aortic Dissection Cooley DA, Morris GC Jr, Crawford ES, Beall AC Jr.
Classification Surgical management of dissecting aneurysms of the
aorta. J Thorac Cardiovasc Surg. 1965 Jan;49:130-49).
C25333 Depth Depth The extent downward or inward; the perpendicular Depth
measurement from the surface downward to determine
deepness. (NCI)
C147148 Dimensionless Index Dimensionless The ratio of the blood velocity in the left ventricular Dimensionless Index
Index;Dimensionless outflow tract (LVOT) to the maximum blood velocity
Velocity Index across the aortic valve.
C139039 Dissection Indicator Dissection Indicator An indication as to whether there is the presence of blood Dissection Indicator
vessel dissection.
C139057 Eccentric Regurgitant Jet Eccentric Regurgitant Jet An indication as to whether an eccentric regurgitant jet Eccentric Regurgitant Jet
Indicator Indicator direction is present. Indicator
C147149 Effective Orifice Area Effective Orifice Area The calculated estimate of the area of a cardiac valve at Effective Orifice Area
the point of maximum opening.
C147150 Effective Orifice Area Effective Orifice Area The ratio of the effective orifice area (EOA) to the body Effective Orifice Area
Index Index surface area (BSA). Index
C127565 Effective Regurgitant Effective Regurgitant A measurement of the effective regurgitant orifice area of Effective Regurgitant
Orifice Area Orifice Area the valve. Orifice Area
C122088 Ejection Wave Amplitude Ejection Wave Amplitude The magnitude of the ejection wave that occurs when Ejection Wave Amplitude
blood is ejected into the aorta by the left ventricle.
C142241 Fractional Area Change Fractional Area Change The percent reduction in the area of a given structure Fractional Area Change
with the following formula: (EDA-ESA)/EDA times 100,
where EDA is end diastolic area and ESA is end systolic
area.
page 324 of 1925

C101846 CVTEST
Code Value
C139062 Heart Chamber Heart Chamber An indication as to whether there is an enlarged heart Heart Chamber
Enlargement Indicator Enlargement Indicator chamber. Enlargement Indicator
C135372 Heart Chamber Volume, Heart Chamber Volume, The volume of blood remaining in a heart chamber at end Heart Chamber Volume at
EVD EVD;Heart Chamber ventricular diastole. End Ventricular Diastole
Volume, End Ventricular
Diastole
C135373 Heart Chamber Volume, Heart Chamber Volume, The volume of blood remaining in a heart chamber at end Heart Chamber Volume at
EVS EVS;Heart Chamber ventricular systole. End Ventricular Systole
Systole
C116148 In-Stent Restenosis In-Stent Restenosis An indication as to whether there is re-narrowing of a In-Stent Restenosis
Indicator Indicator stent implanted at a lesion site to treat a prior stenosis, Indicator
to a diameter stenosis of greater than 50% within the
stent.
C130055 Inferior Vena Cava Inferior Vena Cava An indication as to whether inferior vena cava collapse Inferior Vena Cava
Collapse Sniff Ind Collapse occurred with sniff. Collapse Due to Sniff Test
Indicator;Inferior Vena Indicator
Cava Collapse Sniff Ind
C41255 Interpretation Interpretation An act or process of elucidation; explication, or Interpretation

explanation of the meaning of the event or thing via the
assignment of objects from the domain to the constants
of a formal language, truth-values to the proposition
symbols, truth-functions to the connectives, other
functions to the function symbols, and extensions to the
predicates, if any. The assignments are result of human
logic application and are not native to the symbols of the
formal language.
C80494 Ischemic Myocardium Ischemic Myocardium The percentage of myocardial tissue which exhibits Ischemic Myocardium
Percentage Percentage characteristics of inadequate blood flow (ischemia). Percentage
C127566 Largest Cross-sec Largest Cross-sec The largest cross sectional diameter of a vascular Largest Cross-sectional
Diameter, EVD Diameter, EVD;Largest structure measured at end ventricular diastole. Diameter at End
Cross-sectional Diameter, Ventricular Diastole
End Ventricular Diastole
C127567 Largest Cross-sec Largest Cross-sec The assessment of the largest cross-sectional thickness of Largest Cross-sectional
Thickness Thickness;Largest Cross- a tissue. Thickness
sectional Thickness
C116146 Late Lumen Loss Late Lumen Loss The difference between the mean minimum lumen Late Lumen Loss
diameter (MLD) assessed immediately after an index Measurement
procedure and the MLD assessed at follow-up
angiography.
C99524 Left Ventricular Ejection Left Ventricular Ejection The percent or fraction of the left ventricular end diastolic Left Ventricular Ejection
Fraction Fraction volume ejected during systole that can be measured by Fraction
visual estimation or calculation.
C135374 Left Ventricular Ejection Left Ventricular Ejection A calculated estimation of the percent or fraction of the Calculated Left
Fraction, Cal Fraction, Cal;Left volume of blood ejected from the left ventricle during left Ventricular Ejection
Ventricular Ejection ventricular systole, calculated as the left ventricular Fraction
Fraction, Calculated stroke volume divided by the left ventricular end diastolic
volume.
C135375 Left Ventricular Ejection Left Ventricular Ejection A visual estimation of the percent or fraction of the Estimated Left Ventricular
Fraction, Est Fraction, Est;Left volume of blood ejected from the left ventricle during left Ejection Fraction
Ventricular Ejection ventricular systole.
Fraction, Estimated
C38020 Left Ventricular Fractional Left Ventricular Fractional The reduction in the length of the end-diastolic diameter Left Ventricular Fractional
Shortening Shortening dimension that occurs between end-systole and end- Shortening
diastole, expressed as a fraction of the end-diastolic
dimension. Calculation of the left ventricular fractional
shortening is per the following formula: [(end-diastolic
dimension minus end-systolic dimension) divided by end-
diastolic dimension] multiplied by 100.
C142243 Left Ventricular Mass Left Ventricular Mass The left ventricular mass divided by the subject's body Left Ventricular Mass
Index Index surface area. Index
C142242 Left Ventricular Mass, Left Ventricular Mass, The weight of the left ventricle in grams as estimated by Estimated Mass of Left
Estimated Estimated a formula that uses estimated measurements from Ventricle
echocardiographic exams, as well as constants like the
specific gravity of the myocardium. Left ventricular mass
is estimated using the following equation, LV Mass (g) =
0.8 {1.04[([LVEDD + IVSd + PWd]^3 - LVEDD^3)]} +
0.6, where LVEDD is LV end-diastolic dimension, IVSd is
interventricular septal thickness at end-diastole, and PWd
is posterior wall thickness at end-diastole.
page 325 of 1925

C101846 CVTEST
Code Value
C25334 Length Length The linear extent in space from one end of something to Length
to end. (NCI)
C116147 Lesion Restenosis Lesion Restenosis An indication as to whether there is re-narrowing of a Lesion Restenosis
Indicator Indicator lesion site following treatment of a prior stenosis, to a Indicator
diameter stenosis of greater than 50% at the previously
treated lesion site.
C127568 LVOT Peak Velocity LVOT Peak Velocity;Left A measurement of the maximum velocity of blood flow Left Ventricular Outflow
Ventricular Outflow Tract measured in the left ventricular outflow tract during left Tract Peak Velocity
Peak Velocity ventricular systole.
C127569 LVOT Velocity Time LVOT Velocity Time The integral of all of the instantaneous flow velocities Left Ventricular Outflow
Integral Integral;Left Ventricular within the left ventricular outflow tract during left Tract Velocity Time
Outflow Tract Velocity ventricular systole. Integral
Time Integral
C127573 Major Axis Cross-sec Major Axis Cross-sec The cross sectional diameter of a cardiovascular structure Major Axis Cross-
Diameter, EVD Diameter, EVD;Major Axis measured along its major axis at end ventricular diastole. sectional Diameter at End
C127574 Major Axis Cross-sec Major Axis Cross-sec The cross sectional diameter of a cardiovascular structure Major Axis Cross-
Diameter, EVS Diameter, EVS;Major Axis measured along its major axis at end ventricular systole. sectional Diameter at End
Cross-sectional Diameter, Ventricular Systole
End Ventricular Systole
C135377 Major Axis Cross-sec. Major Axis Cross-sec. The cross sectional diameter of a tissue, organ, or Major Axis Cross-
Diameter Diameter;Major Axis structure measured along its major axis. (NCI) sectional Diameter
Cross-sectional Diameter
C139053 Major Axis Cross-sec. Major Axis Cross-sec. The cross-sectional diameter of a cardiovascular structure Major Axis Cross-
Diameter, MVS Diameter, MVS;Major measured along its major axis at mid ventricular systole. sectional Diameter at Mid
Axis Cross-sectional Ventricular Systole
Systole
C139059 Major Axis Internal Major Axis Internal The internal diameter of a cardiovascular structure Major Axis Internal
Diameter, EVD Diameter, EVD;Major Axis measured along its major axis at end ventricular diastole. Diameter at End
Internal Diameter, End Ventricular Diastole
C139058 Major Axis Internal Major Axis Internal The internal diameter of a cardiovascular structure Major Axis Internal
Diameter, EVS Diameter, EVS;Major Axis measured along its major axis at end ventricular systole. Diameter at End
Internal Diameter, End Ventricular Systole
Ventricular Systole
C43246 Mass Mass The amount of matter in an object. Mass
C139048 Maximal Pericardial Maximal Pericardial The quantitative measurement of the maximum Maximal Pericardial
Effusion Width Effusion Width separation between the parietal and visceral pericardia Effusion Width
during diastole.
C127570 Mean Blood Flow Velocity Mean Blood Flow Velocity A measurement of the mean velocity of blood across an Mean Blood Flow Velocity
area or tissue.
C135376 Mean Blood Pressure, Mean Blood Pressure, The estimated average blood pressure. (NCI) Estimated Mean Blood
Estimated Estimated Pressure
C147152 Mean Pressure Gradient Mean Pressure Gradient A value that represents the mean pressure gradient that Mean Pressure Gradient
exists between two points across a structure.
C116143 Mean Vessel Diameter Mean Vessel Diameter The mean of the inside diameters of the normal blood Mean Vessel Diameter
vessel segments.
C116144 Minimum Vessel Lumen Minimum Vessel Lumen The minimum diameter of the inside of a blood vessel Minimum Vessel Lumen
Diameter Diameter (lumen) derived quantitatively in a single view. Diameter
C127575 Minor Axis Cross-sec Minor Axis Cross-sec The cross sectional diameter of a cardiovascular structure Minor Axis Cross-sectional
Diameter, EVD Diameter, EVD;Minor Axis measured along its minor axis at end ventricular diastole. Diameter at End
C127576 Minor Axis Cross-sec Minor Axis Cross-sec The cross sectional diameter of a cardiovascular structure Minor Axis Cross-sectional
Diameter, EVS Diameter, EVS;Minor Axis measured along its minor axis at end ventricular systole. Diameter at End
C135378 Minor Axis Cross-sec. Minor Axis Cross-sec. The cross sectional diameter of a tissue, organ, or Minor Axis Cross-sectional
Diameter Diameter;Minor Axis structure measured along its minor axis. (NCI) Diameter
page 326 of 1925

C101846 CVTEST
Code Value
C139052 Minor Axis Cross-sec. Minor Axis Cross-sec. The cross-sectional diameter of a cardiovascular structure Minor Axis Cross-sectional
Diameter, MVS Diameter, MVS;Minor measured along its minor axis at mid ventricular systole. Diameter at Mid
Systole
C139061 Minor Axis Internal Minor Axis Internal The internal diameter of a cardiovascular structure Minor Axis Internal
Diameter, EVD Diameter, EVD;Minor Axis measured along its minor axis at end ventricular diastole. Diameter at End
C139060 Minor Axis Internal Minor Axis Internal The internal diameter of a cardiovascular structure Minor Axis Internal
Diameter, EVS Diameter, EVS;Minor Axis measured along its minor axis at end ventricular systole. Diameter at End
Ventricular Systole
C127571 Mitral E/A Ratio Mitral E/A Ratio The ratio of the peak early ventricular diastolic (E) Mitral E/A Ratio
transmitral velocity to the peak late ventricular diastolic
(A) transmitral velocity.
C127572 Mitral E/e' Ratio Mitral E/e' Ratio The ratio of the peak early ventricular diastolic (E) Mitral E/e' Ratio
transmitral velocity to the peak early mitral annular
motion velocity (e').
C127577 Mitral Regur Jet Area L Mitral Regur Jet Area L A relative measurement (ratio) of the mitral regurgitant Mitral Regurgitant Jet
Atrial Area Rt Atrial Area Rt;Mitral jet area to left atrial area. Area to Left Atrial Area
Regurgitant Jet Area to Ratio
Left Atrial Area Ratio
C127578 Mitral Valve Regurgitant Mitral Valve Regurgitant A measurement of the volume of retrograde blood flow Mitral Valve Regurgitant
Fraction Fraction across the orifice of the mitral valve expressed as a Fraction
C127579 Mitral Valve Regurgitant Mitral Valve Regurgitant The measured area of the regurgitant jet of blood into the Mitral Valve Regurgitant
Jet Area Jet Area left atrium. Jet Area
C127580 Mitral Valve Regurgitant Mitral Valve Regurgitant A measurement of the volume of retrograde blood flow Mitral Valve Regurgitant
Volume Volume across the orifice of the mitral valve. Volume
C127581 Mitral Valve Vena Mitral Valve Vena The area of the vena contracta of the mitral valve. Mitral Valve Vena
C127582 Mitral Valve Vena Mitral Valve Vena The width of the vena contracta of the mitral valve. Mitral Valve Vena
C139043 Myocardial Performance Myocardial Performance A calculated result that uses the following base formula to Myocardial Performance
Index Index quantify both systolic and diastolic ventricular function: Index
MPI = (IVCT + IVRT)/VET, where IVCT is isovolumetric
contraction time, IVRT is isovolumetric relaxation time,
and VET is ventricular ejection time.
C139050 Native Cardiac Valve Native Cardiac Valve A description of what kind of intervention has been Native Cardiac Valve
Intervention Type Intervention Type performed on a native cardiac valve. Intervention Type
C139054 Number of Cusps Number of Cusps A quantitative determination of the number of cusps Number of Cardiac Valve
composing a given cardiac valve. Cusps
C99996 Number of Diseased Number of Diseased Number of major epicardial vessels with greater than or Number of Diseased
Coronary Vessels Coronary Vessels equal to 70% reduction in diameter or greater than or Coronary Artery Vessels
equal to 50% reduction in cross-sectional area.
C146994 Obs Med Device Type In Obs Med Device Type In A description of the type of medical device that is found Observed Medical Device
Intended Loc Intended Loc;Observed in a subject and is in its intended location. Type In Intended
Medical Device In The Location
Intended Location
C147153 Obs Med Device Type Not Obs Med Device Type Not A description of the type of medical device that is found Observed Medical Device
In Intended Loc In Intended Loc in a subject but is not in its intended location. Type Not Present In
Intended Location Type
C147151 Observed Foreign Body Observed Foreign Body An indication as to whether a medical or non-medical Observed Foreign Body
Indicator Indicator foreign body is present in a subject. Indicator
C147154 Observed Non-Medical Observed Non-Medical A description of the type of non-medical foreign body that Observed Non-Medical
Foreign Body Type Foreign Body Type is found in a subject. Foreign Body Type
C127584 Peak A Velocity Peak A Velocity The peak velocity of blood flow across a cardiac valve Peak A Velocity
during late ventricular diastole (the active filling of the
ventricle).
C127583 Peak Blood Flow Velocity Peak Blood Flow Velocity A measurement of the maximum velocity of blood across Peak Blood Flow Velocity
an area or tissue.
page 327 of 1925

C101846 CVTEST
Code Value
C127585 Peak E Velocity Peak E Velocity The peak velocity of blood flow across a cardiac valve Peak E Velocity
during early ventricular diastole (the passive filling of the
ventricle).
C147155 Peak Pressure Gradient Peak Pressure Gradient A value that represents the maximum pressure gradient Peak Pressure Gradient
that exists between two points across a structure.
C139044 Peak Pressure Rise Rate Peak Pressure Rise Rate The greatest rate of increase in peak pressure. Peak Pressure Rise Rate
C116145 Percent Diameter Percent Diameter The value calculated as 100 x (1 - MLD/RVD), using the Percent Diameter
Stenosis Stenosis mean quantitative values for minimum lumen diameter Stenosis Measurement
(MLD) and reference vessel diameter (RVD).
C139046 Pericardial Effusion Pericardial Effusion An indication as to whether there is effusion between the Pericardial Effusion
Indicator Indicator parietal and visceral pericardia. Indicator
C139047 Pericardial Effusion Size Pericardial Effusion Size The qualitative description of the overall size of a Pericardial Effusion Size
pericardial effusion as assessed at the point of greatest
separation between the parietal and visceral pericardia
during diastole.
C147156 Pressure Half Time Pressure Half Time The amount of time required for the peak transvalvular Pressure Half Time
pressure gradient to decrease to one half of the value.
C139051 Prosthetic Cardiac Valve Prosthetic Cardiac Valve A description of the type of artificial cardiac valve in use. Prosthetic Cardiac Valve
Type Type Type
C135379 Pulmonary Arterial Pulmonary Arterial An indication as to whether pulmonary arterial Pulmonary Arterial
Hypertension Ind Hypertension hypertension is present. Hypertension Indicator
Ind;Pulmonary Arterial
Hypertension Indicator
C127588 Pulmonary Valve Pulmonary Valve A measurement of the volume of retrograde blood flow Pulmonary Valve
Regurgitant Fraction Regurgitant Fraction across the orifice of the pulmonic valve expressed as a Regurgitant Fraction
C127590 Pulmonary Valve Pulmonary Valve A measurement of the volume of retrograde blood flow Pulmonary Valve
Regurgitant Volume Regurgitant Volume across the orifice of the pulmonic valve. Regurgitant Volume
C127591 Pulmonary Valve Vena Pulmonary Valve Vena The area of the vena contracta of the pulmonic valve. Pulmonary Valve Vena
C127592 Pulmonary Valve Vena Pulmonary Valve Vena The width of the vena contracta of the pulmonic valve. Pulmonary Valve Vena
C119247 Pulmonary Vascular Pulmonary Vascular The resistance to blood flow through the pulmonary Pulmonary Vascular
Resistance Resistance vasculature. Resistance
C127587 Pulmonary Vein Pulmonary Vein The determination of whether blood flow in the Pulmonary Vein
Dominance Dominance pulmonary veins is greater during ventricular systole or Dominance
diastole.
C127586 Pulmonic Regur Jet Width Pulmonic Regur Jet Width A relative measurement (ratio) of the pulmonic Pulmonic Regurgitant Jet
RVOT Diam Rt RVOT Diam Rt;Pulmonic regurgitant jet width to right ventricular outflow tract Width to Right Ventricular
Regurgitant Jet Width to (RVOT) diameter. Outflow Tract Diameter
Right Ventricular Outflow Ratio
C127589 Pulmonic Valve Pulmonic Valve The measured width of the regurgitant jet of blood into Pulmonic Valve
Regurgitant Jet Width Regurgitant Jet Width the right ventricular outflow tract. Regurgitant Jet Width
C122087 Pulse Wave Velocity Pulse Wave Velocity The distance traveled by the peak of the ventricular Pulse Wave Velocity
ejection pressure wave per unit of time.
C122089 Reflection Magnitude Reflection Magnitude The reflected-to-forward pressure wave amplitude ratio. Reflection Magnitude
(Hashimoto J et al, J Hypertens. 2008 May;26(5):1017-
24)
C122090 Reflection Wave Reflection Wave The summation of the numerous waves being reflected by Reflection Wave
Amplitude Amplitude sites of impedance mismatch where central elastic Amplitude
arteries join more muscular arteries.
C135380 Right Ventricular Ejection Right Ventricular Ejection A calculated estimation of the percent or fraction of the Calculated Right
Fraction, Cal Fraction, Cal;Right volume of blood ejected from the right ventricle during Ventricular Ejection
Ventricular Ejection right ventricular systole, calculated as the right Fraction
Fraction, Calculated ventricular stroke volume divided by the right ventricular
end diastolic volume.
C135381 Right Ventricular Ejection Right Ventricular Ejection A visual estimation of the percent or fraction of the Estimated Right
Fraction, Est Fraction, Est;Right volume of blood ejected from the right ventricle during Ventricular Ejection
Ventricular Ejection right ventricular systole. Fraction
Fraction, Estimated
page 328 of 1925

C101846 CVTEST
Code Value
C139040 Stanford AoD Stanford AoD The type of aortic dissection present as defined by the Stanford Aortic Dissection
Classification Classification;Stanford Stanford Classification System (Daily PO, Trueblood HW, Classification
Aortic Dissection Stinson EB, Wuerflein RD, Shumway NE. Management of
Classification acute aortic dissections. Ann Thorac Surg. 1970
Sep;10(3):237-47).
C94989 Stroke Volume Stroke Volume The difference in the volumes of blood between the points Stroke Volume
of maximum dilation and maximum contraction. This is
the end diastolic volume minus the end systolic volume.
C119248 Systemic Vascular Systemic Vascular The resistance to blood flow through the systemic Systemic Vascular
Resistance Resistance;Total vasculature. Resistance
Peripheral Resistance
C127593 Systolic Anterior Motion SAM Indicator;Systolic An indication as to whether there is systolic anterior Systolic Anterior Motion
Indicator Anterior Motion Indicator motion of a cardiac valve and its associated structures. Indicator
C127594 Systolic Anterior Motion SAM Severity;Systolic The assessment of the severity of the systolic anterior Systolic Anterior Motion
Severity Anterior Motion Severity motion of a cardiac valve and its associated structures. Severity
C139031 Systolic Pressure, Systolic Pressure, A quantitative estimate of the pressure in a given Estimated Systolic Blood
Estimated Estimated cardiovascular structure during ventricular systole. Pressure
C127597 Tricus Regur Jet Area R Tricus Regur Jet Area R A relative measurement (ratio) of the tricuspid Tricuspid Regurgitant Jet
Atrial Area Rt Atrial Area Rt;Tricuspid regurgitant jet area to the right atrial area. Area to Right Atrial Area
Right Atrial Area Ratio
C127598 Tricuspid Valve Tricuspid Valve A measurement of the volume of retrograde blood flow Tricuspid Valve
Regurgitant Fraction Regurgitant Fraction across the orifice of the tricuspid valve expressed as a Regurgitant Fraction
C127599 Tricuspid Valve Tricuspid Valve The measured area of the regurgitant jet of blood into the Tricuspid Valve
Regurgitant Jet Area Regurgitant Jet Area right atrium. Regurgitant Jet Area
C127600 Tricuspid Valve Tricuspid Valve A measurement of the volume of retrograde blood flow Tricuspid Valve
Regurgitant Volume Regurgitant Volume across the orifice of the tricuspid valve. Regurgitant Volume
C127601 Tricuspid Valve Vena Tricuspid Valve Vena The area of the vena contracta of the tricuspid valve. Tricuspid Valve Vena
C127602 Tricuspid Valve Vena Tricuspid Valve Vena The width of the vena contracta of the tricuspid valve. Tricuspid Valve Vena
C147158 Valve Area Valve Area The quantitative measurement estimating the surface Valve Area
area of a valve.
C147157 Valve Area Index Valve Area Index The ratio of the valve area to the body surface area. Valve Area Index
C127603 Velocity Time Integral, Velocity Time Integral, The integral of all of the forward flow velocities during the Blood Flow Velocity Time
Blood Flow Blood Flow time of blood flow across or within a specified area. Integral
C25208 Weight Weight The vertical force exerted by a mass as a result of Weight
gravity. (NCI)
C25345 Width Width The extent or measurement of something from side to Width
side. (NCI)
page 329 of 1925

CVTESTCD (Cardiovascular Test Code)
C101847 CVTESTCD
Code Value
C122038 AAUGIX Aortic Augmentation The augmentation pressure divided by the aortic pulse Aortic Augmentation
Index pressure (aortic systolic minus aortic diastolic pressure) Index
multiplied by 100, expressed as a percentage.
C122083 AAUGIX75 Aortic Augmentation The aortic augmentation index normalized to a heart rate Aortic Augmentation
Index at 75bpm of 75 beats per minute. Index at 75bpm
C122084 AAUGPR Aortic Augmentation The difference between the second pressure peak in the Aortic Augmentation
Pressure aortic wave, secondary to the pressure wave reflection Pressure
from the sites of peripheral arterial impedance mismatch
(P2) and the first pressure peak in the aortic wave form,
secondary to ventricular ejection (P1).
C122085 AAUGPRP1 Aortic Augmentation The first pressure peak in the aortic wave form secondary Augmentation Pressure
Pressure Peak P1 to ventricular ejection. Point P1
C122086 AAUGPRP2 Aortic Augmentation The second pressure peak in the aortic waveform Augmentation Pressure
Pressure Peak P2 secondary to pressure wave reflection from the periphery. Point P2
C139033 ACRCTIND Aortic Coarctation An indication as to whether there is coarctation of the Aortic Coarctation
Indicator aorta. Indicator
C139037 ACRCTSEV Aortic Coarctation The assessment of the severity of aortic coarctation. Aortic Coarctation
Severity Severity
C139035 ADUCSEV Aortic Ductal Coarctation The assessment of the severity of ductal aortic Aortic Juxta-ductal
Severity;Aortic Juxta- coarctation. Coarctation Severity
ductal Coarctation
Severity
C139038 ANEURIND Aneurysm Indicator An indication as to whether there is the presence of one Aneurysm Indicator
or more aneurysms.
C127535 ANNAVEL Annular a' Velocity The peak velocity of the annular motion during late Annular a' Velocity
ventricular diastole (the active filling of the ventricle).
C127536 ANNEVEL Annular e' Velocity The peak velocity of the annular motion during early Annular e' Velocity
ventricular diastole (the passive filling of the ventricle).
C139045 ANNSVEL Annular S' Velocity The peak velocity of the annular motion during ventricular Annular S' Velocity
systole.
C139036 APOSCSEV Aortic Postductal The assessment of the severity of postductal aortic Aortic Postductal
Coarctation Severity coarctation. Coarctation Severity
C139034 APRECSEV Aortic Preductal The assessment of the severity of preductal aortic Aortic Preductal
Coarctation Severity coarctation. Coarctation Severity
C139042 APSE Annular Plane Systolic The longitudinal displacement of a cardiac valve annulus Annular Plane Systolic
Excursion toward the apex of the heart. Excursion
C127537 AREAEVD Area, End Ventricular The 2-dimensional surface enclosed within a boundary of Area at End Ventricular
Diastole a cardiovascular structure and measured at end Diastole
ventricular diastole.
C127538 AREAEVS Area, End Ventricular The 2-dimensional surface enclosed within a boundary of Area at End Ventricular
Systole a cardiovascular structure and measured at end Systole
ventricular systole.
C127539 ARGJWLVD Aortic Regur Jet Width A relative measurement (ratio) of the aortic regurgitant Aortic Regurgitant Jet
LVOT Diam Rt;Aortic jet width to left ventricular outflow tract (LVOT) diameter. Width to Left Ventricular
Regurgitant Jet Width to Outflow Tract Diameter
Left Ventricular Outflow Ratio
C127540 AVRGF Aortic Valve Regurgitant A measurement of the volume of retrograde blood flow Aortic Valve Regurgitant
Fraction across the orifice of the aortic valve expressed as a Fraction
C127541 AVRGJW Aortic Valve Regurgitant The measured width of the regurgitant jet of blood into Aortic Valve Regurgitant
Jet Width the left ventricular outflow tract. Jet Width
C127542 AVRGVOL Aortic Valve Regurgitant A measurement of the volume of retrograde blood flow Aortic Valve Regurgitant
Volume across the orifice of the aortic valve. Volume
C127543 AVVCA Aortic Valve Vena The area of the vena contracta of the aortic valve. Aortic Valve Vena
Contracta Area Contracta Area
page 330 of 1925

C101847 CVTESTCD
Code Value
C127544 AVVCW Aortic Valve Vena The width of the vena contracta of the aortic valve. Aortic Valve Vena
Contracta Width Contracta Width
C94866 BLDFLRT Blood Flow Rate The volume of blood per unit time passing through a Blood Flow Rate
specified location, such as a point in a blood vessel or an
entire organ.
C119331 CANRFIND Coronary Artery No An indication as to whether there is a new acute Coronary No Reflow at
Reflow Indicator reduction in coronary flow (TIMI grade 0-1) in the PCI Site Indicator
absence of dissection, thrombus, spasm, or high-grade
residual stenosis at the original PCI lesion site.
C119245 CARDIDX Cardiac Index The measure of an individual's cardiac output divided by Cardiac Index
the individual's body surface area (CI= CO/BSA).
C119246 CARDOUT Cardiac Output The total volume of blood pumped by the heart over a set Cardiac Output
period of time, conventionally one minute; it is calculated
as heart rate times stroke volume (CO= HR x SV).
C139063 CMHYIND Cardiac Muscle An indication as to whether there is a hypertrophied Heart Chamber
Hypertrophy Indicator cardiac muscle. Hypertrophy Indicator
C100086 COARTDOM Coronary Artery The pattern of the epicardial vessels supplying the Coronary Artery
Dominance posterolateral and posterior descending coronary arteries. Dominance
C139032 CSDIA Cross-sectional Diameter A measurement of a structure taken along the plane that Cross-sectional Diameter
is perpendicular to the long axis.
C127545 CSDIAEVD Cross-sec Diameter, The cross sectional diameter of a cardiovascular structure Cross-sectional Diameter
EVD;Cross-sectional measured at end ventricular diastole. at End Ventricular
Diameter, End Ventricular Diastole
Diastole
C127546 CSDIAEVS Cross-sec Diameter, The cross sectional diameter of a cardiovascular structure Cross-sectional Diameter
EVS;Cross-sectional measured at end ventricular systole. at End Ventricular Systole
Diameter, End Ventricular
Systole
C127547 CSDIAMVS Cross-sec Diameter, The cross sectional diameter of a cardiovascular structure Cross-sectional Diameter
MVS;Cross-sectional measured at mid ventricular systole. at Mid Ventricular Systole
Systole
C127548 CSPDIND Cusp Doming Indicator An indication as to whether there is doming of a cardiac Cusp Doming Indicator
valve cusp.
C127549 CSPDSEV Cusp Doming Severity The assessment of the severity of doming of a cardiac Cusp Doming Severity
valve cusp.
C127550 CSPFIND Cusp Flail Indicator An indication as to whether there is a flailing cardiac Cusp Flail Indicator
valve cusp.
C127551 CSPFSEV Cusp Flail Severity The assessment of the severity of a flailing cardiac valve Cusp Flail Severity
cusp.
C127552 CSPFT Cusp Flail Timing The time point during the cardiac cycle when the flail of Cusp Flail Timing
one or more cardiac valve cusps occurs.
C127553 CSPPIND Cusp Prolapse Indicator An indication as to whether there is a prolapsing cardiac Cusp Prolapse Indicator
valve cusp.
C127554 CSPPSEV Cusp Prolapse Severity The assessment of the severity of a prolapsing cardiac Cusp Prolapse Severity
valve cusp.
C127555 CSPPT Cusp Prolapse Timing The time point during the cardiac cycle when the prolapse Cusp Prolapse Timing
of one or more cardiac valve cusps occurs.
C127556 CSPRMIND Cusp Restricted Motion An indication as to whether there is restricted motion of a Cusp Restricted Motion
Indicator cardiac valve cusp. Indicator
C127557 CSPRMSEV Cusp Restricted Motion The assessment of the severity of restricted motion of a Cusp Restricted Motion
Severity cardiac valve cusp. Severity
C127558 CSPTEIND Cusp Tethering Indicator An indication as to whether there is tethering of a cardiac Cusp Tethering Indicator
valve cusp.
C127559 CSPTESEV Cusp Tethering Severity The assessment of the severity of tethering of a cardiac Cusp Tethering Severity
valve cusp.
C127560 CSPTIND Cusp Thickening Indicator An indication as to whether there is a thickened cardiac Cusp Thickening Indicator
valve cusp.
page 331 of 1925

C101847 CVTESTCD
Code Value
C127561 CSPTSEV Cusp Thickening Severity The assessment of the severity of a thickening cardiac Cusp Thickening Severity
cusp.
C127562 CTPIND Chordae Tendineae An indication as to whether there is prolapsing of a Chordae Tendineae
Prolapse Indicator cardiac valve chordae tendinae. Prolapse Indicator
C102244 CVLREGTS Cardiac Valvular The qualitative measurement of the severity of cardiac Cardiac Valvular
Regurgitation Severity valvular regurgitation. Regurgitation Severity
C102245 CVLSTNS Cardiac Valvular Stenosis The qualitative measurement of the severity of cardiac Cardiac Valvular Stenosis
Severity valvular stenosis. Severity
C139055 CVRGIND Cardiac Valvular An indication as to whether a specific cardiac valve is Cardiac Valvular
Regurgitation Indicator regurgitant. Regurgitation Indicator
C127563 CVRGJDR Cardiac Valve Regur Jet The trajectory of the retrograde blood flow from a cardiac Cardiac Valve Regurgitant
Direction;Cardiac Valve valve. Jet Direction
Regurgitation Jet
Direction
C139056 CVRGLE Cardiac Valvular Regur An estimation as to the cause of the pathology Cardiac Valvular
Likely Etiology;Cardiac responsible for the cardiac valve regurgitation. Regurgitation Likely
Valvular Regurgitation Etiology
Likely Etiology
C127564 CWMTYP Cardiac Wall Motion Type The assessment of the movement of the cardiac muscle, Cardiac Wall Motion Type
either as a whole or at one or more specific anatomical
locations.
C139041 DEBAKADC DeBakey AoD The type of aortic dissection present as defined by the DeBakey Aortic Dissection
Classification;DeBakey DeBakey Classification System (DeBakey ME, Henly WS, Classification
Aortic Dissection Cooley DA, Morris GC Jr, Crawford ES, Beall AC Jr.
Classification Surgical management of dissecting aneurysms of the
aorta. J Thorac Cardiovasc Surg. 1965 Jan;49:130-49).
C25333 DEPTH Depth The extent downward or inward; the perpendicular Depth
measurement from the surface downward to determine
deepness. (NCI)
C147148 DIMSSNDX Dimensionless The ratio of the blood velocity in the left ventricular Dimensionless Index
Index;Dimensionless outflow tract (LVOT) to the maximum blood velocity
Velocity Index across the aortic valve.
C139039 DISECIND Dissection Indicator An indication as to whether there is the presence of blood Dissection Indicator
vessel dissection.
C127565 EFFRGOA Effective Regurgitant A measurement of the effective regurgitant orifice area of Effective Regurgitant
Orifice Area the valve. Orifice Area
C122088 EJWAMP Ejection Wave Amplitude The magnitude of the ejection wave that occurs when Ejection Wave Amplitude
blood is ejected into the aorta by the left ventricle.
C147149 EOA Effective Orifice Area The calculated estimate of the area of a cardiac valve at Effective Orifice Area
the point of maximum opening.
C147150 EOAINDEX Effective Orifice Area The ratio of the effective orifice area (EOA) to the body Effective Orifice Area
Index surface area (BSA). Index
C139057 ERGJIND Eccentric Regurgitant Jet An indication as to whether an eccentric regurgitant jet Eccentric Regurgitant Jet
Indicator direction is present. Indicator
C142241 FAC Fractional Area Change The percent reduction in the area of a given structure Fractional Area Change
with the following formula: (EDA-ESA)/EDA times 100,
where EDA is end diastolic area and ESA is end systolic
area.
C147151 FBODYIND Observed Foreign Body An indication as to whether a medical or non-medical Observed Foreign Body
Indicator foreign body is present in a subject. Indicator
C139062 HCENLIND Heart Chamber An indication as to whether there is an enlarged heart Heart Chamber
Enlargement Indicator chamber. Enlargement Indicator
C135372 HCVOLEVD Heart Chamber Volume, The volume of blood remaining in a heart chamber at end Heart Chamber Volume at
EVD;Heart Chamber ventricular diastole. End Ventricular Diastole
Diastole
C135373 HCVOLEVS Heart Chamber Volume, The volume of blood remaining in a heart chamber at end Heart Chamber Volume at
EVS;Heart Chamber ventricular systole. End Ventricular Systole
Systole
page 332 of 1925

C101847 CVTESTCD
Code Value
C116148 INRSTIND In-Stent Restenosis An indication as to whether there is re-narrowing of a In-Stent Restenosis
Indicator stent implanted at a lesion site to treat a prior stenosis, Indicator
to a diameter stenosis of greater than 50% within the
stent.
C41255 INTP Interpretation An act or process of elucidation; explication, or Interpretation

formal language.
C80494 ISHMYOP Ischemic Myocardium The percentage of myocardial tissue which exhibits Ischemic Myocardium
Percentage characteristics of inadequate blood flow (ischemia). Percentage
C130055 IVCCSIND Inferior Vena Cava An indication as to whether inferior vena cava collapse Inferior Vena Cava
Collapse occurred with sniff. Collapse Due to Sniff Test
Indicator;Inferior Vena Indicator
Cava Collapse Sniff Ind
C127566 LCDIAEVD Largest Cross-sec The largest cross sectional diameter of a vascular Largest Cross-sectional
Diameter, EVD;Largest structure measured at end ventricular diastole. Diameter at End
C25334 LENGTH Length The linear extent in space from one end of something to Length
to end. (NCI)
C127567 LGTHCK Largest Cross-sec The assessment of the largest cross-sectional thickness of Largest Cross-sectional
Thickness;Largest Cross- a tissue. Thickness
sectional Thickness
C116146 LLMLOSS Late Lumen Loss The difference between the mean minimum lumen Late Lumen Loss
diameter (MLD) assessed immediately after an index Measurement
procedure and the MLD assessed at follow-up
angiography.
C116147 LRSTIND Lesion Restenosis An indication as to whether there is re-narrowing of a Lesion Restenosis
Indicator lesion site following treatment of a prior stenosis, to a Indicator
diameter stenosis of greater than 50% at the previously
treated lesion site.
C99524 LVEF Left Ventricular Ejection The percent or fraction of the left ventricular end diastolic Left Ventricular Ejection
Fraction volume ejected during systole that can be measured by Fraction
visual estimation or calculation.
C135374 LVEF_C Left Ventricular Ejection A calculated estimation of the percent or fraction of the Calculated Left
Fraction, Cal;Left volume of blood ejected from the left ventricle during left Ventricular Ejection
Ventricular Ejection ventricular systole, calculated as the left ventricular Fraction
Fraction, Calculated stroke volume divided by the left ventricular end diastolic
volume.
C135375 LVEF_E Left Ventricular Ejection A visual estimation of the percent or fraction of the Estimated Left Ventricular
Fraction, Est;Left volume of blood ejected from the left ventricle during left Ejection Fraction
Ventricular Ejection ventricular systole.
Fraction, Estimated
C38020 LVFS Left Ventricular Fractional The reduction in the length of the end-diastolic diameter Left Ventricular Fractional
Shortening dimension that occurs between end-systole and end- Shortening
diastole, expressed as a fraction of the end-diastolic
dimension. Calculation of the left ventricular fractional
shortening is per the following formula: [(end-diastolic
dimension minus end-systolic dimension) divided by end-
diastolic dimension] multiplied by 100.
C142242 LVMAS_E Left Ventricular Mass, The weight of the left ventricle in grams as estimated by Estimated Mass of Left
Estimated a formula that uses estimated measurements from Ventricle
echocardiographic exams, as well as constants like the
specific gravity of the myocardium. Left ventricular mass
is estimated using the following equation, LV Mass (g) =
0.8 {1.04[([LVEDD + IVSd + PWd]^3 - LVEDD^3)]} +
0.6, where LVEDD is LV end-diastolic dimension, IVSd is
interventricular septal thickness at end-diastole, and PWd
is posterior wall thickness at end-diastole.
C142243 LVMASIDX Left Ventricular Mass The left ventricular mass divided by the subject's body Left Ventricular Mass
Index surface area. Index
C127568 LVOTPVEL LVOT Peak Velocity;Left A measurement of the maximum velocity of blood flow Left Ventricular Outflow
Ventricular Outflow Tract measured in the left ventricular outflow tract during left Tract Peak Velocity
Peak Velocity ventricular systole.
page 333 of 1925

C101847 CVTESTCD
Code Value
C127569 LVOTVTI LVOT Velocity Time The integral of all of the instantaneous flow velocities Left Ventricular Outflow
Integral;Left Ventricular within the left ventricular outflow tract during left Tract Velocity Time
Outflow Tract Velocity ventricular systole. Integral
Time Integral
C43246 MASS Mass The amount of matter in an object. Mass
C139048 MAXPEFFW Maximal Pericardial The quantitative measurement of the maximum Maximal Pericardial
Effusion Width separation between the parietal and visceral pericardia Effusion Width
during diastole.
C127570 MBFVEL Mean Blood Flow Velocity A measurement of the mean velocity of blood across an Mean Blood Flow Velocity
area or tissue.
C135376 MEANBP_E Mean Blood Pressure, The estimated average blood pressure. (NCI) Estimated Mean Blood
Estimated Pressure
C116143 MEANVDIA Mean Vessel Diameter The mean of the inside diameters of the normal blood Mean Vessel Diameter
vessel segments.
C147152 MGPRES Mean Pressure Gradient A value that represents the mean pressure gradient that Mean Pressure Gradient
exists between two points across a structure.
C116144 MINLDIAM Minimum Vessel Lumen The minimum diameter of the inside of a blood vessel Minimum Vessel Lumen
Diameter (lumen) derived quantitatively in a single view. Diameter
C127571 MITRALEA Mitral E/A Ratio The ratio of the peak early ventricular diastolic (E) Mitral E/A Ratio
transmitral velocity to the peak late ventricular diastolic
(A) transmitral velocity.
C127572 MITRALEE Mitral E/e' Ratio The ratio of the peak early ventricular diastolic (E) Mitral E/e' Ratio
transmitral velocity to the peak early mitral annular
motion velocity (e').
C135377 MJDIA Major Axis Cross-sec. The cross sectional diameter of a tissue, organ, or Major Axis Cross-
Diameter;Major Axis structure measured along its major axis. (NCI) sectional Diameter
C127573 MJDIAEVD Major Axis Cross-sec The cross sectional diameter of a cardiovascular structure Major Axis Cross-
Diameter, EVD;Major Axis measured along its major axis at end ventricular diastole. sectional Diameter at End
C127574 MJDIAEVS Major Axis Cross-sec The cross sectional diameter of a cardiovascular structure Major Axis Cross-
Diameter, EVS;Major Axis measured along its major axis at end ventricular systole. sectional Diameter at End
C139053 MJDIAMVS Major Axis Cross-sec. The cross-sectional diameter of a cardiovascular structure Major Axis Cross-
Diameter, MVS;Major measured along its major axis at mid ventricular systole. sectional Diameter at Mid
Systole
C139059 MJIDEVD Major Axis Internal The internal diameter of a cardiovascular structure Major Axis Internal
Diameter, EVD;Major Axis measured along its major axis at end ventricular diastole. Diameter at End
C139058 MJIDEVS Major Axis Internal The internal diameter of a cardiovascular structure Major Axis Internal
Diameter, EVS;Major Axis measured along its major axis at end ventricular systole. Diameter at End
Ventricular Systole
C135378 MNDIA Minor Axis Cross-sec. The cross sectional diameter of a tissue, organ, or Minor Axis Cross-sectional
Diameter;Minor Axis structure measured along its minor axis. (NCI) Diameter
C127575 MNDIAEVD Minor Axis Cross-sec The cross sectional diameter of a cardiovascular structure Minor Axis Cross-sectional
Diameter, EVD;Minor Axis measured along its minor axis at end ventricular diastole. Diameter at End
C127576 MNDIAEVS Minor Axis Cross-sec The cross sectional diameter of a cardiovascular structure Minor Axis Cross-sectional
Diameter, EVS;Minor Axis measured along its minor axis at end ventricular systole. Diameter at End
C139052 MNDIAMVS Minor Axis Cross-sec. The cross-sectional diameter of a cardiovascular structure Minor Axis Cross-sectional
Diameter, MVS;Minor measured along its minor axis at mid ventricular systole. Diameter at Mid
Systole
page 334 of 1925

C101847 CVTESTCD
Code Value
C139061 MNIDEVD Minor Axis Internal The internal diameter of a cardiovascular structure Minor Axis Internal
Diameter, EVD;Minor Axis measured along its minor axis at end ventricular diastole. Diameter at End
C139060 MNIDEVS Minor Axis Internal The internal diameter of a cardiovascular structure Minor Axis Internal
Diameter, EVS;Minor Axis measured along its minor axis at end ventricular systole. Diameter at End
Ventricular Systole
C139043 MPI Myocardial Performance A calculated result that uses the following base formula to Myocardial Performance
Index quantify both systolic and diastolic ventricular function: Index
MPI = (IVCT + IVRT)/VET, where IVCT is isovolumetric
contraction time, IVRT is isovolumetric relaxation time,
and VET is ventricular ejection time.
C127577 MRGJALA Mitral Regur Jet Area L A relative measurement (ratio) of the mitral regurgitant Mitral Regurgitant Jet
Atrial Area Rt;Mitral jet area to left atrial area. Area to Left Atrial Area
Left Atrial Area Ratio
C127578 MVRGF Mitral Valve Regurgitant A measurement of the volume of retrograde blood flow Mitral Valve Regurgitant
Fraction across the orifice of the mitral valve expressed as a Fraction
C127579 MVRGJA Mitral Valve Regurgitant The measured area of the regurgitant jet of blood into the Mitral Valve Regurgitant
Jet Area left atrium. Jet Area
C127580 MVRGVOL Mitral Valve Regurgitant A measurement of the volume of retrograde blood flow Mitral Valve Regurgitant
Volume across the orifice of the mitral valve. Volume
C127581 MVVCA Mitral Valve Vena The area of the vena contracta of the mitral valve. Mitral Valve Vena
C127582 MVVCW Mitral Valve Vena The width of the vena contracta of the mitral valve. Mitral Valve Vena
C139050 NCVALTYP Native Cardiac Valve A description of what kind of intervention has been Native Cardiac Valve
Intervention Type performed on a native cardiac valve. Intervention Type
C139054 NUMCUSPS Number of Cusps A quantitative determination of the number of cusps Number of Cardiac Valve
composing a given cardiac valve. Cusps
C99996 NUMDCAV Number of Diseased Number of major epicardial vessels with greater than or Number of Diseased
Coronary Vessels equal to 70% reduction in diameter or greater than or Coronary Artery Vessels
equal to 50% reduction in cross-sectional area.
C146994 OBMDILOC Obs Med Device Type In A description of the type of medical device that is found Observed Medical Device
Intended Loc;Observed in a subject and is in its intended location. Type In Intended
Medical Device In The Location
Intended Location
C147153 OBMDNLOC Obs Med Device Type Not A description of the type of medical device that is found Observed Medical Device
In Intended Loc in a subject but is not in its intended location. Type Not Present In
Intended Location Type
C147154 OBNMFBT Observed Non-Medical A description of the type of non-medical foreign body that Observed Non-Medical
Foreign Body Type is found in a subject. Foreign Body Type
C135379 PAHTNIND Pulmonary Arterial An indication as to whether pulmonary arterial Pulmonary Arterial
Hypertension hypertension is present. Hypertension Indicator
Ind;Pulmonary Arterial
Hypertension Indicator
C127583 PBFVEL Peak Blood Flow Velocity A measurement of the maximum velocity of blood across Peak Blood Flow Velocity
an area or tissue.
C116145 PCTDIAST Percent Diameter The value calculated as 100 x (1 - MLD/RVD), using the Percent Diameter
Stenosis mean quantitative values for minimum lumen diameter Stenosis Measurement
(MLD) and reference vessel diameter (RVD).
C139051 PCVALTYP Prosthetic Cardiac Valve A description of the type of artificial cardiac valve in use. Prosthetic Cardiac Valve
Type Type
C139046 PEFFIND Pericardial Effusion An indication as to whether there is effusion between the Pericardial Effusion
Indicator parietal and visceral pericardia. Indicator
C139047 PEFFSIZE Pericardial Effusion Size The qualitative description of the overall size of a Pericardial Effusion Size
pericardial effusion as assessed at the point of greatest
separation between the parietal and visceral pericardia
during diastole.
page 335 of 1925

C101847 CVTESTCD
Code Value
C147155 PGPRES Peak Pressure Gradient A value that represents the maximum pressure gradient Peak Pressure Gradient
that exists between two points across a structure.
C127584 PKAVEL Peak A Velocity The peak velocity of blood flow across a cardiac valve Peak A Velocity
during late ventricular diastole (the active filling of the
ventricle).
C127585 PKEVEL Peak E Velocity The peak velocity of blood flow across a cardiac valve Peak E Velocity
during early ventricular diastole (the passive filling of the
ventricle).
C139044 PPRR Peak Pressure Rise Rate The greatest rate of increase in peak pressure. Peak Pressure Rise Rate
C147156 PRESHT Pressure Half Time The amount of time required for the peak transvalvular Pressure Half Time
pressure gradient to decrease to one half of the value.
C127586 PRGJWRVD Pulmonic Regur Jet Width A relative measurement (ratio) of the pulmonic Pulmonic Regurgitant Jet
RVOT Diam Rt;Pulmonic regurgitant jet width to right ventricular outflow tract Width to Right Ventricular
Regurgitant Jet Width to (RVOT) diameter. Outflow Tract Diameter
Right Ventricular Outflow Ratio
C127587 PVEINDOM Pulmonary Vein The determination of whether blood flow in the Pulmonary Vein
Dominance pulmonary veins is greater during ventricular systole or Dominance
diastole.
C119247 PVR Pulmonary Vascular The resistance to blood flow through the pulmonary Pulmonary Vascular
Resistance vasculature. Resistance
C127588 PVRGF Pulmonary Valve A measurement of the volume of retrograde blood flow Pulmonary Valve
Regurgitant Fraction across the orifice of the pulmonic valve expressed as a Regurgitant Fraction
C127589 PVRGJW Pulmonic Valve The measured width of the regurgitant jet of blood into Pulmonic Valve
Regurgitant Jet Width the right ventricular outflow tract. Regurgitant Jet Width
C127590 PVRGVOL Pulmonary Valve A measurement of the volume of retrograde blood flow Pulmonary Valve
Regurgitant Volume across the orifice of the pulmonic valve. Regurgitant Volume
C127591 PVVCA Pulmonary Valve Vena The area of the vena contracta of the pulmonic valve. Pulmonary Valve Vena
C127592 PVVCW Pulmonary Valve Vena The width of the vena contracta of the pulmonic valve. Pulmonary Valve Vena
C122087 PWV Pulse Wave Velocity The distance traveled by the peak of the ventricular Pulse Wave Velocity
ejection pressure wave per unit of time.
C122089 RFLMAG Reflection Magnitude The reflected-to-forward pressure wave amplitude ratio. Reflection Magnitude
(Hashimoto J et al, J Hypertens. 2008 May;26(5):1017-
24)
C122090 RFLWAMP Reflection Wave The summation of the numerous waves being reflected by Reflection Wave
Amplitude sites of impedance mismatch where central elastic Amplitude
arteries join more muscular arteries.
C135380 RVEF_C Right Ventricular Ejection A calculated estimation of the percent or fraction of the Calculated Right
Fraction, Cal;Right volume of blood ejected from the right ventricle during Ventricular Ejection
Ventricular Ejection right ventricular systole, calculated as the right Fraction
Fraction, Calculated ventricular stroke volume divided by the right ventricular
end diastolic volume.
C135381 RVEF_E Right Ventricular Ejection A visual estimation of the percent or fraction of the Estimated Right
Fraction, Est;Right volume of blood ejected from the right ventricle during Ventricular Ejection
Ventricular Ejection right ventricular systole. Fraction
Fraction, Estimated
C127593 SAMIND SAM Indicator;Systolic An indication as to whether there is systolic anterior Systolic Anterior Motion
Anterior Motion Indicator motion of a cardiac valve and its associated structures. Indicator
C127594 SAMSEV SAM Severity;Systolic The assessment of the severity of the systolic anterior Systolic Anterior Motion
Anterior Motion Severity motion of a cardiac valve and its associated structures. Severity
C139040 STANFADC Stanford AoD The type of aortic dissection present as defined by the Stanford Aortic Dissection
Classification;Stanford Stanford Classification System (Daily PO, Trueblood HW, Classification
Aortic Dissection Stinson EB, Wuerflein RD, Shumway NE. Management of
Classification acute aortic dissections. Ann Thorac Surg. 1970
Sep;10(3):237-47).
C94989 STROKVOL Stroke Volume The difference in the volumes of blood between the points Stroke Volume
of maximum dilation and maximum contraction. This is
the end diastolic volume minus the end systolic volume.
page 336 of 1925

C101847 CVTESTCD
Code Value
C119248 SVR Systemic Vascular The resistance to blood flow through the systemic Systemic Vascular
Resistance;Total vasculature. Resistance
Peripheral Resistance
C139031 SYSPRS_E Systolic Pressure, A quantitative estimate of the pressure in a given Estimated Systolic Blood
Estimated cardiovascular structure during ventricular systole. Pressure
C127595 THCKEVD Cross-sec Thickness, The cross-sectional thickness of a cardiovascular Cross-sectional Thickness
EVD;Cross-sectional structure measured at end ventricular diastole. at End Ventricular
Thickness, End Diastole
C127596 THCKEVS Cross-sec Thickness, The cross-sectional thickness of a cardiovascular Cross-sectional Thickness
EVS;Cross-sectional structure measured at end ventricular systole. at End Ventricular Systole
Thickness, End
Ventricular Systole
C127597 TRGJARA Tricus Regur Jet Area R A relative measurement (ratio) of the tricuspid Tricuspid Regurgitant Jet
Atrial Area Rt;Tricuspid regurgitant jet area to the right atrial area. Area to Right Atrial Area
Right Atrial Area Ratio
C127598 TVRGF Tricuspid Valve A measurement of the volume of retrograde blood flow Tricuspid Valve
Regurgitant Fraction across the orifice of the tricuspid valve expressed as a Regurgitant Fraction
C127599 TVRGJA Tricuspid Valve The measured area of the regurgitant jet of blood into the Tricuspid Valve
Regurgitant Jet Area right atrium. Regurgitant Jet Area
C127600 TVRGVOL Tricuspid Valve A measurement of the volume of retrograde blood flow Tricuspid Valve
Regurgitant Volume across the orifice of the tricuspid valve. Regurgitant Volume
C127601 TVVCA Tricuspid Valve Vena The area of the vena contracta of the tricuspid valve. Tricuspid Valve Vena
C127602 TVVCW Tricuspid Valve Vena The width of the vena contracta of the tricuspid valve. Tricuspid Valve Vena
C147157 VAREANDX Valve Area Index The ratio of the valve area to the body surface area. Valve Area Index
C127603 VELTI Velocity Time Integral, The integral of all of the forward flow velocities during the Blood Flow Velocity Time
Blood Flow time of blood flow across or within a specified area. Integral
C142244 VLSTNIND Cardiac Valvular Stenosis An indication as to whether the cardiac valve in question Cardiac Valvular Stenosis
Indicator has stenosis. Indicator
C142245 VLSTNSLE Cardiac Valve Stenosis A description of the likely cause of the pathology Cardiac Valve Stenosis
Likely Etiology responsible for the cardiac valve stenosis. Likely Etiology
C147158 VLVAREA Valve Area The quantitative measurement estimating the surface Valve Area
area of a valve.
C25208 WEIGHT Weight The vertical force exerted by a mass as a result of Weight
gravity. (NCI)
C25345 WIDTH Width The extent or measurement of something from side to Width
side. (NCI)
page 337 of 1925

D4STR1TC (Descend 4 Stairs Functional Test Test Code)
C141661 D4STR1TC
Code Value
C141704 D4STR101 D4STR1-Time to Descend 4 Stair Descend - Time taken to descend 4 stairs. 4 Stair Descend - Time to
4 Stairs Descend 4 Stairs
C141705 D4STR102 D4STR1-Test Grade 4 Stair Descend - Test grade. 4 Stair Descend - Test
Grade
C147591 D4STR103 D4STR1-Wear Orthoses 4 Stair Descend - Did subject wear orthoses? 4 Stair Descend - Wear
Orthoses
page 338 of 1925

D4STR1TN (Descend 4 Stairs Functional Test Test Name)
C141660 D4STR1TN
Code Value
C141705 D4STR1-Test Grade D4STR1-Test Grade 4 Stair Descend - Test grade. 4 Stair Descend - Test
Grade
C141704 D4STR1-Time to Descend D4STR1-Time to Descend 4 Stair Descend - Time taken to descend 4 stairs. 4 Stair Descend - Time to
4 Stairs 4 Stairs Descend 4 Stairs
C147591 D4STR1-Wear Orthoses D4STR1-Wear Orthoses 4 Stair Descend - Did subject wear orthoses? 4 Stair Descend - Wear
Orthoses
page 339 of 1925

DAD01TC (Disability Assessment for Dementia Questionnaire Test Code)
C105130 DAD01TC
Code Value
C105170 DAD0101 DAD01-Decide to Wash Disability Assessment for Dementia - Decide to wash DAD - Decide to Wash or
himself/herself or to take a bath or shower? Take a Bath or Shower
C105171 DAD0102 DAD01-Decide to Brush Disability Assessment for Dementia - Decide to brush DAD - Decide to Brush
Teeth Dentures his/her teeth or care for his/her dentures? Teeth or Care for
Dentures
C105172 DAD0103 DAD01-Decide to Care Disability Assessment for Dementia - Decide to care for DAD - Decide to Care for
For Hair his/her hair (wash and comb)? His/Her Hair
C105173 DAD0104 DAD01-Prepare For Disability Assessment for Dementia - Prepare the water, DAD - Prepare the Water,
Washing Bath Shower towels, and soap for washing, taking a bath or a shower? Towels, and Soap for
Washing, Taking a Bath
or Shower
C105174 DAD0105 DAD01-Wash and Dry Disability Assessment for Dementia - Wash and dry all DAD - Wash and Dry All
Body Safely parts of his/her body safely and completely? Parts of Body Safely and
Completely
C105175 DAD0106 DAD01-Brush Teeth Take Disability Assessment for Dementia - Brush his/her teeth DAD - Brush Teeth or
Care of Dentures or take care of his/her dentures appropriately? Take Care of Dentures
Appropriately
C105176 DAD0107 DAD01-Take Care of Hair Disability Assessment for Dementia - Take care of his/her DAD - Take Care of
hair (wash and comb)? His/Her Hair
C105177 DAD0108 DAD01-Decide to Dress Disability Assessment for Dementia - Decide to dress DAD - Decide to Dress
himself/herself? Himself/Herself
C105178 DAD0109 DAD01-Choose Disability Assessment for Dementia - Choose appropriate DAD - Choose
Appropriate Clothing clothing (with regard to the occasion, neatness, the Appropriate Clothing
weather and color combination)?
C105179 DAD0110 DAD01-Dress in Disability Assessment for Dementia - Dress DAD - Dress in the
Appropriate Order himself/herself in the appropriate order (undergarments, Appropriate Order
pant/dress, shoes)?
C105180 DAD0111 DAD01-Dress Completely Disability Assessment for Dementia - Dress DAD - Dress
himself/herself completely? Himself/Herself
Completely
C105181 DAD0112 DAD01-Undress Disability Assessment for Dementia - Undress DAD - Undress
Completely himself/herself completely? Himself/Herself
Completely
C105182 DAD0113 DAD01-Use Toilet at Disability Assessment for Dementia - Decide to use the DAD - Decide to Use the
Appropriate Times toilet at appropriate times? Toilet at Appropriate
Times
C105183 DAD0114 DAD01-Use Toilet Without Disability Assessment for Dementia - Use the toilet DAD - Use the Toilet
Accidents without 'accidents'? Without Accidents
C105184 DAD0115 DAD01-Decide That Disability Assessment for Dementia - Decide that he/she DAD - Decide That
He/She Needs to Eat needs to eat? He/She Needs to Eat
C105185 DAD0116 DAD01-Choose Disability Assessment for Dementia - Choose appropriate DAD - Choose
Appropriate Utensils utensils and seasonings when eating? Appropriate Utensils and
Seasonings When Eating
C105186 DAD0117 DAD01-Eat at Normal Disability Assessment for Dementia - Eat his/her meals at DAD - Eat Meals at a
Pace With Manners a normal pace and with appropriate manners? Normal Pace and with
Appropriate Manners
C105187 DAD0118 DAD01-Decide to Prepare Disability Assessment for Dementia - Decide to prepare a DAD - Decide to Prepare
Meal Snack light meal or snack for himself/herself? a Light Meal or Snack for
Himself/Herself
C105188 DAD0119 DAD01-Adequately Plan Disability Assessment for Dementia - Adequately plan a DAD - Adequately Plan a
Light Meal Snack light meal or snack (ingredients, cookware)? Light Meal or Snack
C105189 DAD0120 DAD01-Prepare or Cook Disability Assessment for Dementia - Prepare or cook a DAD - Safely Prepare or
Light Meal Snack light meal or a snack safely? Cook a Light Meal or
Snack
C105190 DAD0121 DAD01-Telephone Disability Assessment for Dementia - Attempt to DAD - Attempt to
Someone at Suitable telephone someone at a suitable time? Telephone Someone at a
Time Suitable Time
page 340 of 1925

C105130 DAD01TC
Code Value
C105191 DAD0122 DAD01-Find and Dial Disability Assessment for Dementia - Find and dial a DAD - Find and Dial a
Telephone Number telephone number correctly? Telephone Number
Correctly
C105192 DAD0123 DAD01-Carry Out Disability Assessment for Dementia - Carry out an DAD - Carry Out an
Telephone Conversation appropriate telephone conversation? Appropriate Telephone
Conversation
C105193 DAD0124 DAD01-Write Convey Disability Assessment for Dementia - Write and convey a DAD - Write and Convey
Telephone Message telephone message adequately? a Telephone Message
Adequately
C105194 DAD0125 DAD01-Decide to Go Out Disability Assessment for Dementia - Decide to go out DAD - Decide to Go Out
(walk, visit, shop) at an appropriate time? at an Appropriate Time
C105195 DAD0126 DAD01-Adequately Disability Assessment for Dementia - Adequately organize DAD - Adequately
Organize an Outing an outing with respect to transportation, keys, Organize an Outing with
destination, weather, necessary money, shopping list? Respect to
Transportation, Keys,
Destination, Weather,
Money, Shopping List
C105196 DAD0127 DAD01-Go Out Without Disability Assessment for Dementia - Go out and reach a DAD - Go Out and Reach
Getting Lost familiar destination without getting lost? a Familiar Destination
Without Getting Lost
C105197 DAD0128 DAD01-Safely Take Disability Assessment for Dementia - Safely take the DAD - Safely Take the
Transportation adequate mode of transportation (car, bus, taxi)? Adequate Mode of
Transportation
C105198 DAD0129 DAD01-Return From Disability Assessment for Dementia - Return from the DAD - Return From the
Store With Items store with the appropriate items? Store with Appropriate
Items
C105199 DAD0130 DAD01-Show Interest in Disability Assessment for Dementia - Show an interest in DAD - Show an Interest
Personal Affairs his/her personal affairs such as his/her finances and in Personal Affairs such
written correspondence? as Finances and Written
Correspondence
C105200 DAD0131 DAD01-Organize Finances Disability Assessment for Dementia - Organize his/her DAD - Organize Finances
to Pay Bills finances to pay his/her bills (checks, bank statement, to Pay Bills
bills)?
C105201 DAD0132 DAD01-Adequately Disability Assessment for Dementia - Adequately organize DAD - Adequately
Organize Correspondence his/her correspondence with respect to stationery, Organize Correspondence
address, stamps?
C105202 DAD0133 DAD01-Handle Money Disability Assessment for Dementia - Handle his/her DAD - Handle Money
Adequately money adequately (deal with cash)? Adequately
C105203 DAD0134 DAD01-Take Medications Disability Assessment for Dementia - Decide to take DAD - Decide to Take
at Correct Time his/her medications at the correct time? Medications at the
Correct Time
C105204 DAD0135 DAD01-Take Medications Disability Assessment for Dementia - Take his/her DAD - Take Medications
as Prescribed medications as prescribed (according to the right as Prescribed
dosage)?
C105205 DAD0136 DAD01-Show Interest in Disability Assessment for Dementia - Show an interest in DAD - Show an Interest
Leisure Activity leisure activity(ies)? in Leisure Activities
C105206 DAD0137 DAD01-Take Interest in Disability Assessment for Dementia - Take an interest in DAD - Take an Interest in
Household Chores household chores that he/she used to perform in the Household Chores as in
past? the Past
C105207 DAD0138 DAD01-Plan Organize Disability Assessment for Dementia - Plan and organize DAD - Plan and Organize
Household Chores adequately household chores that he/she used to perform Adequately Household
in the past? Chores as in the Past
C105208 DAD0139 DAD01-Complete Disability Assessment for Dementia - Complete household DAD - Complete
Household Chores chores adequately as he/she used to perform in the past? Household Chores
Adequately as in the Past
C105209 DAD0140 DAD01-Stay Safely at Disability Assessment for Dementia - Stay safely at home DAD - Stay Safely at
Home When Needed by himself/herself when needed? Home When Needed
C111577 DAD0141 DAD01-Sub-Total Disability Assessment for Dementia - Sub-Total Initiation. DAD - Sub-Total Initiation
Initiation
C111578 DAD0142 DAD01-Initiation Num Disability Assessment for Dementia - Sub-Total Initiation DAD - Total Initiation
Applic Items Number of Applicable Items. Number of Applicable
Items
page 341 of 1925

C105130 DAD01TC
Code Value
C111579 DAD0143 DAD01-Sub-Total Disability Assessment for Dementia - Sub-Total Planning DAD - Sub-Total Planning
Planning & Organization & Organization. and Organization
C111617 DAD0144 DAD01-Plan & Org Num Disability Assessment for Dementia - Sub-Total Planning DAD - Plan and Organize
Applic Items & Organization Number of Applicable Items. Number of Applicable
Items
C111580 DAD0145 DAD01-Sub-Total Disability Assessment for Dementia - Sub-Total Effective DAD - Sub-Total Effective
Effective Performance Performance. Performance
C111581 DAD0146 DAD01-Effective Perf Disability Assessment for Dementia - Sub-Total Effective DAD - Sub-Total Effective
Num Applic Items Performance Number of Applicable Items. Performance Number of
Applicable Items
C111582 DAD0147 DAD01-Total Score Disability Assessment for Dementia - Total Score. DAD - Total Score
C111583 DAD0148 DAD01-Total Num of Disability Assessment for Dementia - Total Number of DAD - Total Number of
Applic Items Applicable Items. Applicable Items
C111584 DAD0149 DAD01-Total % Disability Assessment for Dementia - Total %. DAD - Total Percent
page 342 of 1925

DAD01TN (Disability Assessment for Dementia Questionnaire Test Name)
C105129 DAD01TN
Code Value
C105195 DAD01-Adequately DAD01-Adequately Disability Assessment for Dementia - Adequately organize DAD - Adequately
Organize an Outing Organize an Outing an outing with respect to transportation, keys, Organize an Outing with
destination, weather, necessary money, shopping list? Respect to
Transportation, Keys,
Destination, Weather,
Money, Shopping List
C105201 DAD01-Adequately DAD01-Adequately Disability Assessment for Dementia - Adequately organize DAD - Adequately
Organize Correspondence Organize Correspondence his/her correspondence with respect to stationery, Organize Correspondence
address, stamps?
C105188 DAD01-Adequately Plan DAD01-Adequately Plan Disability Assessment for Dementia - Adequately plan a DAD - Adequately Plan a
Light Meal Snack Light Meal Snack light meal or snack (ingredients, cookware)? Light Meal or Snack
C105175 DAD01-Brush Teeth Take DAD01-Brush Teeth Take Disability Assessment for Dementia - Brush his/her teeth DAD - Brush Teeth or
Care of Dentures Care of Dentures or take care of his/her dentures appropriately? Take Care of Dentures
Appropriately
C105192 DAD01-Carry Out DAD01-Carry Out Disability Assessment for Dementia - Carry out an DAD - Carry Out an
Telephone Conversation Telephone Conversation appropriate telephone conversation? Appropriate Telephone
Conversation
C105178 DAD01-Choose DAD01-Choose Disability Assessment for Dementia - Choose appropriate DAD - Choose
Appropriate Clothing Appropriate Clothing clothing (with regard to the occasion, neatness, the Appropriate Clothing
weather and color combination)?
C105185 DAD01-Choose DAD01-Choose Disability Assessment for Dementia - Choose appropriate DAD - Choose
Appropriate Utensils Appropriate Utensils utensils and seasonings when eating? Appropriate Utensils and
Seasonings When Eating
C105208 DAD01-Complete DAD01-Complete Disability Assessment for Dementia - Complete household DAD - Complete
Household Chores Household Chores chores adequately as he/she used to perform in the past? Household Chores
Adequately as in the Past
C105184 DAD01-Decide That DAD01-Decide That Disability Assessment for Dementia - Decide that he/she DAD - Decide That
He/She Needs to Eat He/She Needs to Eat needs to eat? He/She Needs to Eat
C105171 DAD01-Decide to Brush DAD01-Decide to Brush Disability Assessment for Dementia - Decide to brush DAD - Decide to Brush
Teeth Dentures Teeth Dentures his/her teeth or care for his/her dentures? Teeth or Care for
Dentures
C105172 DAD01-Decide to Care DAD01-Decide to Care Disability Assessment for Dementia - Decide to care for DAD - Decide to Care for
For Hair For Hair his/her hair (wash and comb)? His/Her Hair
C105177 DAD01-Decide to Dress DAD01-Decide to Dress Disability Assessment for Dementia - Decide to dress DAD - Decide to Dress
himself/herself? Himself/Herself
C105194 DAD01-Decide to Go Out DAD01-Decide to Go Out Disability Assessment for Dementia - Decide to go out DAD - Decide to Go Out
(walk, visit, shop) at an appropriate time? at an Appropriate Time
C105187 DAD01-Decide to Prepare DAD01-Decide to Prepare Disability Assessment for Dementia - Decide to prepare a DAD - Decide to Prepare
Meal Snack Meal Snack light meal or snack for himself/herself? a Light Meal or Snack for
Himself/Herself
C105170 DAD01-Decide to Wash DAD01-Decide to Wash Disability Assessment for Dementia - Decide to wash DAD - Decide to Wash or
himself/herself or to take a bath or shower? Take a Bath or Shower
C105180 DAD01-Dress Completely DAD01-Dress Completely Disability Assessment for Dementia - Dress DAD - Dress
himself/herself completely? Himself/Herself
Completely
C105179 DAD01-Dress in DAD01-Dress in Disability Assessment for Dementia - Dress DAD - Dress in the
Appropriate Order Appropriate Order himself/herself in the appropriate order (undergarments, Appropriate Order
pant/dress, shoes)?
C105186 DAD01-Eat at Normal DAD01-Eat at Normal Disability Assessment for Dementia - Eat his/her meals at DAD - Eat Meals at a
Pace With Manners Pace With Manners a normal pace and with appropriate manners? Normal Pace and with
Appropriate Manners
C111581 DAD01-Effective Perf DAD01-Effective Perf Disability Assessment for Dementia - Sub-Total Effective DAD - Sub-Total Effective
Num Applic Items Num Applic Items Performance Number of Applicable Items. Performance Number of
Applicable Items
C105191 DAD01-Find and Dial DAD01-Find and Dial Disability Assessment for Dementia - Find and dial a DAD - Find and Dial a
Telephone Number Telephone Number telephone number correctly? Telephone Number
Correctly
page 343 of 1925

C105129 DAD01TN
Code Value
C105196 DAD01-Go Out Without DAD01-Go Out Without Disability Assessment for Dementia - Go out and reach a DAD - Go Out and Reach
Getting Lost Getting Lost familiar destination without getting lost? a Familiar Destination
Without Getting Lost
C105202 DAD01-Handle Money DAD01-Handle Money Disability Assessment for Dementia - Handle his/her DAD - Handle Money
Adequately Adequately money adequately (deal with cash)? Adequately
C111578 DAD01-Initiation Num DAD01-Initiation Num Disability Assessment for Dementia - Sub-Total Initiation DAD - Total Initiation
Applic Items Applic Items Number of Applicable Items. Number of Applicable
Items
C105200 DAD01-Organize Finances DAD01-Organize Finances Disability Assessment for Dementia - Organize his/her DAD - Organize Finances
to Pay Bills to Pay Bills finances to pay his/her bills (checks, bank statement, to Pay Bills
bills)?
C111617 DAD01-Plan & Org Num DAD01-Plan & Org Num Disability Assessment for Dementia - Sub-Total Planning DAD - Plan and Organize
Applic Items Applic Items & Organization Number of Applicable Items. Number of Applicable
Items
C105207 DAD01-Plan Organize DAD01-Plan Organize Disability Assessment for Dementia - Plan and organize DAD - Plan and Organize
Household Chores Household Chores adequately household chores that he/she used to perform Adequately Household
in the past? Chores as in the Past
C105173 DAD01-Prepare For DAD01-Prepare For Disability Assessment for Dementia - Prepare the water, DAD - Prepare the Water,
Washing Bath Shower Washing Bath Shower towels, and soap for washing, taking a bath or a shower? Towels, and Soap for
Washing, Taking a Bath
or Shower
C105189 DAD01-Prepare or Cook DAD01-Prepare or Cook Disability Assessment for Dementia - Prepare or cook a DAD - Safely Prepare or
Light Meal Snack Light Meal Snack light meal or a snack safely? Cook a Light Meal or
Snack
C105198 DAD01-Return From DAD01-Return From Disability Assessment for Dementia - Return from the DAD - Return From the
Store With Items Store With Items store with the appropriate items? Store with Appropriate
Items
C105197 DAD01-Safely Take DAD01-Safely Take Disability Assessment for Dementia - Safely take the DAD - Safely Take the
Transportation Transportation adequate mode of transportation (car, bus, taxi)? Adequate Mode of
Transportation
C105205 DAD01-Show Interest in DAD01-Show Interest in Disability Assessment for Dementia - Show an interest in DAD - Show an Interest
Leisure Activity Leisure Activity leisure activity(ies)? in Leisure Activities
C105199 DAD01-Show Interest in DAD01-Show Interest in Disability Assessment for Dementia - Show an interest in DAD - Show an Interest
Personal Affairs Personal Affairs his/her personal affairs such as his/her finances and in Personal Affairs such
written correspondence? as Finances and Written
Correspondence
C105209 DAD01-Stay Safely at DAD01-Stay Safely at Disability Assessment for Dementia - Stay safely at home DAD - Stay Safely at
Home When Needed Home When Needed by himself/herself when needed? Home When Needed
C111580 DAD01-Sub-Total DAD01-Sub-Total Disability Assessment for Dementia - Sub-Total Effective DAD - Sub-Total Effective
Effective Performance Effective Performance Performance. Performance
C111577 DAD01-Sub-Total DAD01-Sub-Total Disability Assessment for Dementia - Sub-Total Initiation. DAD - Sub-Total Initiation
Initiation Initiation
C111579 DAD01-Sub-Total DAD01-Sub-Total Disability Assessment for Dementia - Sub-Total Planning DAD - Sub-Total Planning
Planning & Organization Planning & Organization & Organization. and Organization
C105176 DAD01-Take Care of Hair DAD01-Take Care of Hair Disability Assessment for Dementia - Take care of his/her DAD - Take Care of
hair (wash and comb)? His/Her Hair
C105206 DAD01-Take Interest in DAD01-Take Interest in Disability Assessment for Dementia - Take an interest in DAD - Take an Interest in
Household Chores Household Chores household chores that he/she used to perform in the Household Chores as in
past? the Past
C105204 DAD01-Take Medications DAD01-Take Medications Disability Assessment for Dementia - Take his/her DAD - Take Medications
as Prescribed as Prescribed medications as prescribed (according to the right as Prescribed
dosage)?
C105203 DAD01-Take Medications DAD01-Take Medications Disability Assessment for Dementia - Decide to take DAD - Decide to Take
at Correct Time at Correct Time his/her medications at the correct time? Medications at the
Correct Time
C105190 DAD01-Telephone DAD01-Telephone Disability Assessment for Dementia - Attempt to DAD - Attempt to
Someone at Suitable Someone at Suitable telephone someone at a suitable time? Telephone Someone at a
Time Time Suitable Time
C111584 DAD01-Total % DAD01-Total % Disability Assessment for Dementia - Total %. DAD - Total Percent
C111583 DAD01-Total Num of DAD01-Total Num of Disability Assessment for Dementia - Total Number of DAD - Total Number of
Applic Items Applic Items Applicable Items. Applicable Items
page 344 of 1925

C105129 DAD01TN
Code Value
C111582 DAD01-Total Score DAD01-Total Score Disability Assessment for Dementia - Total Score. DAD - Total Score
C105181 DAD01-Undress DAD01-Undress Disability Assessment for Dementia - Undress DAD - Undress
Completely Completely himself/herself completely? Himself/Herself
Completely
C105182 DAD01-Use Toilet at DAD01-Use Toilet at Disability Assessment for Dementia - Decide to use the DAD - Decide to Use the
Appropriate Times Appropriate Times toilet at appropriate times? Toilet at Appropriate
Times
C105183 DAD01-Use Toilet Without DAD01-Use Toilet Without Disability Assessment for Dementia - Use the toilet DAD - Use the Toilet
Accidents Accidents without 'accidents'? Without Accidents
C105174 DAD01-Wash and Dry DAD01-Wash and Dry Disability Assessment for Dementia - Wash and dry all DAD - Wash and Dry All
Body Safely Body Safely parts of his/her body safely and completely? Parts of Body Safely and
Completely
C105193 DAD01-Write Convey DAD01-Write Convey Disability Assessment for Dementia - Write and convey a DAD - Write and Convey
Telephone Message Telephone Message telephone message adequately? a Telephone Message
Adequately
page 345 of 1925

DATEST (Drug Accountability Test Name)
C78731 DATEST
Code Value
C78721 Dispensed Amount Dispensed Amount The quantity of a product that has been dispensed. (NCI) Dispensed Amount
C78722 Returned Amount Returned Amount The quantity of a product that has been returned. (NCI) Returned Amount
page 346 of 1925

DATESTCD (Drug Accountability Test Code)
C78732 DATESTCD
Code Value
C78721 DISPAMT Dispensed Amount The quantity of a product that has been dispensed. (NCI) Dispensed Amount
C78722 RETAMT Returned Amount The quantity of a product that has been returned. (NCI) Returned Amount
page 347 of 1925

DEACNDEV (Device Events Action Taken with Device)
C111110 DEACNDEV
Code Value
C69187 CALIBRATION The act of checking or adjusting (by comparison with a Calibration
standard) the accuracy of a measuring instrument. (NCI)
C61575 REMOVAL The act of taking out, extracting, or withdrawing an entity Extraction
from a location.
C111306 REPROGRAMMING The act of rewriting program code or application software. Reprogram
(NCI)
page 348 of 1925

DECAT (Category of Device Events)
C111109 DECAT
Code Value
C62994 CALIBRATION FAILURE Calibrate, Failure Issue associated with the failure of the device to perform Failure to Calibrate
To;Failure to Calibrate a self-calibration procedure or process designed to assure Problem
the accuracy and proper performance of the device.
(FDA)
C63269 COMPUTER SOFTWARE Software Malfunction Issue associated with written programs, codes, and/or Computer Software
ISSUE software system that affects device performance or Problem
communication with another device. (NCI)
C116121 DATA STORAGE FAILURE Issue associated with the failure of the software to store Data Storage Failure
collected data.
C62954 DEVICE OPERATIONAL Device Operational Issue associated with any deviations from specifications Medical Device
ISSUE Malfunction relating to device operations (e.g. deployment, Operational Issue
connection, electrical, computer software, infusion/flow,
output, protective-measure, and incompatibility issues).
C112361 NON-STUDY EQUIPMENT Non-Study Equipment Issue associated with any deviations from specifications Non-Study Device Issue
ISSUE Malfunction relating to non-study device or equipment operations.
C111309 SCHEDULED An inspection and/or surveillance activity that has been Scheduled Maintenance
MAINTENANCE anticipated to occur and was assigned a time or date
when that activity is to be performed. (NCI)
C67227 SOFTWARE UPDATE All program coding after initial deployment to correct Software Maintenance
coding errors, enhance the functionality of the software,
and perfect the functioning of the software. (NCI)
page 349 of 1925

DIABTHPY (Diabetes Therapy)
C101857 DIABTHPY
Code Value
C15383 DIET A form of therapy which includes dietary approaches and Special Diet Therapy
special diets.
C581 INSULIN A synthetic or animal-derived form of insulin used in the Therapeutic Insulin
treatment of diabetes mellitus.
C99994 NO TREATMENT No treatment for diabetes. No Treatment for

Diabetes
C102246 ORAL MEDICATION A pharmacological medication intended for administration Oral Medication
through the mouth.
page 350 of 1925

DICTNAM (Dictionary Name)
C66788 DICTNAM
Code Value
C49471 COSTART Coding Symbols for a A terminology developed and used by the Food and Drug Thesaurus of Adverse
Thesaurus of Adverse Administration (FDA) for the coding, filing and retrieving Reaction Term Coding
Reaction Terms of post marketing adverse reaction reports. (NCI) Symbols
C49474 ICD International A system of categories to which morbid entries are International
Classification of Diseases assigned according to established criteria. Included is the Classification of Diseases
entire range of conditions in a manageable number of
categories, grouped to facilitate mortality reporting. It is
produced by the World Health Organization (from ICD-10,
p1). The Clinical Modifications, produced by the United
States Dept. of Health and Human Services, are larger
extensions used for morbidity and general epidemiological
purposes, primarily in the U.S. (MSH2005_2004_10_12)
C49476 LOINC Logical Observation Published by The Regenstrief Institute, the Logical Logical Observation
Identifiers Names and Observation Identifiers Names and Codes covers clinical Identifiers Names and
Codes and clinical laboratory terminology. (NCI) Codes
C43820 MedDRA Medical Dictionary for MedDRA is an international medical terminology designed MedDRA
Regulatory Activities to support the classification, retrieval, presentation, and
communication of medical information throughout the
medical product regulatory cycle. MedDRA was developed
under the auspices of the International Conference on
Harmonisation of Technical Requirements for Registration
of Pharmaceuticals for Human Use (ICH). The MedDRA
Maintenance and Support Services Organization (MSSO)
holds a contract with the International Federation of
Pharmaceutical Manufacturers Associations (IFPMA) to
maintain and support the implementation of the
terminology. (NCI)
C53489 SNOMED Systematized A multiaxial, hierarchical classification system for Systematized

Nomenclature of Medicine diseases in man developed by the College of American Nomenclature of Medicine
Pathologists. (NCI)
C49468 WHOART World Health A terminology implemented by the World Health World Health
Organization Adverse Organization to describe adverse reactions to a prescribed Organization Adverse
Reaction Terms medication or treatment regimen. (NCI) Reaction Terminology
C49475 WHODD World Health A reference source of drugs and drug associated World Health
Organization Drug information maintained by the World Health Organization. Organization Drug
Dictionary (NCI) Dictionary
page 351 of 1925

DIPARM (Device Identifier Long Name)
C106480 DIPARM
Code Value
C104504 Batch Number Batch Identifier;Batch A distinctive alpha-numeric identification code assigned Batch Number
Number by the manufacturer or distributor to a specific quantity
of manufactured material or product that is produced in a
manner that is expected to render it homogeneous.
C99286 Catalog Number Catalog Number A unique manufacturer-assigned identifier used to Catalog Number
distinguish a specific product from others in a catalog of
products offered.
C53265 Device Type Device Type Generic category of medical device within the device Type of Device
classification established by a regulatory authority.
C112279 FDA Unique Device FDA Unique Device A UDI is a unique numeric or alphanumeric code that FDA Unique Device
Identification Identification includes a device identifier, which is specific to a device Identifier
model, and a production identifier, which includes the
current production information for that specific device,
such as the lot or batch number, the serial number
and/or expiration date. (FDA)
C70848 Lot Number Lot Identifier;Lot Number A distinctive alpha-numeric identification code assigned Lot Number
by the manufacturer or distributor to a specific quantity
of manufactured material or product within a batch.
C25392 Manufacturer Manufacturer The organization defined as being responsible for creating Manufacturer
the product as stated on the package in which the
product is supplied. (BRIDG)
C99285 Model Number Model Identifier;Model The identifier assigned to a particular design of a device, Model Number
Number usually an alphanumeric text string.
C111191 Secure Lead Type Secure Lead Type The type of locking device used to securely fasten the Electrical Lead Locking
electrical leads to the device. (NCI) Type
C73518 Serial Number Serial Number A unique identifier assigned to an individual object. Serial Number
C106570 Stereotactic Surgery Stereotactic Surgery The classification of the cage structure used to immobilize Stereotactic Surgery
Frame Type Frame Type the head or other body part in preparation for stereotactic Frame Type
surgery. (NCI)
C71898 Trade Name Trade Name The part of the name or logo associated with a specific Proprietary Name
product or service identifying and distinguishing it from
varieties of the same product or service marketed by
competing companies.
page 352 of 1925

DIPARMCD (Device Identifier Short Name)
C106481 DIPARMCD
Code Value
C104504 BATCH Batch Identifier;Batch A distinctive alpha-numeric identification code assigned Batch Number
Number by the manufacturer or distributor to a specific quantity
of manufactured material or product that is produced in a
manner that is expected to render it homogeneous.
C99286 CATNUM Catalog Number A unique manufacturer-assigned identifier used to Catalog Number
distinguish a specific product from others in a catalog of
products offered.
C53265 DEVTYPE Device Type Generic category of medical device within the device Type of Device
classification established by a regulatory authority.
C112279 FDAUDI FDA Unique Device A UDI is a unique numeric or alphanumeric code that FDA Unique Device
Identification includes a device identifier, which is specific to a device Identifier
model, and a production identifier, which includes the
current production information for that specific device,
such as the lot or batch number, the serial number
and/or expiration date. (FDA)
C70848 LOT Lot Identifier;Lot Number A distinctive alpha-numeric identification code assigned Lot Number
by the manufacturer or distributor to a specific quantity
of manufactured material or product within a batch.
C25392 MANUF Manufacturer The organization defined as being responsible for creating Manufacturer
the product as stated on the package in which the
product is supplied. (BRIDG)
C99285 MODEL Model Identifier;Model The identifier assigned to a particular design of a device, Model Number
Number usually an alphanumeric text string.
C111191 SECURLD Secure Lead Type The type of locking device used to securely fasten the Electrical Lead Locking
electrical leads to the device. (NCI) Type
C73518 SERIAL Serial Number A unique identifier assigned to an individual object. Serial Number
C106570 SFMTYP Stereotactic Surgery The classification of the cage structure used to immobilize Stereotactic Surgery
Frame Type the head or other body part in preparation for stereotactic Frame Type
surgery. (NCI)
C71898 TRADENAM Trade Name The part of the name or logo associated with a specific Proprietary Name
product or service identifying and distinguishing it from
varieties of the same product or service marketed by
competing companies.
page 353 of 1925

DIR (Directionality)
C99074 DIR
Code Value
C25231 ANTERIOR Denoting the front portion of the body or a structure. Anterior
C147159 ANTEROMEDIAL Denoting the front portion of the body towards the Anteromedial
median plane.
C25423 APICAL Relating to or located at the apex. Apical
C90067 BASAL Relating to or located at the lowest portion of a structure. Basal
C73851 CAUDAL Toward the tail in a body. Caudal
C25445 CENTRAL A point or area that is approximately central within some Center
larger region or structure. (NCI)
C37936 CRANIAL Toward the head in a body. Cranial
C25240 DEEP Extending relatively far inward. (NCI) Deep
C25237 DISTAL Situated farthest from a point of reference. Distal
C147160 DISTAL VOLAR Pertaining to the farthest portion from the palm side of a Distal Volar
hand or the sole side of a foot.
C45874 DORSAL Pertaining to the back or upper surface of the body. Dorsal
C90376 DORSOLATERAL Toward the back and side of a body. Dorsolateral
C90386 FORE Of or involving the front of a main body. (NCI) Fore
C90393 HIND Of or involving the back of a main body. (NCI) Hind
C25353 INFERIOR Pertaining to a point below a given reference point. Inferior
C37980 INNER Inside or closer to the inside of the body or object. (NCI) Inner
C73705 INTERMEDIATE Located between two points or extremes. Intermediate
C25230 LATERAL Situated at or extending to the side. Lateral
C25309 LOWER The bottom one of two. (NCI) Lower
C147161 LOWER EXTENSOR Pertaining to the lower portion of the surface on the Lower Extensor Surface
SURFACE opposite side of the joint when it bends.
C147162 LOWER FLEXOR SURFACE Pertaining to the lower portion of the surface on the same Lower Flexor Surface
side of the joint when it bends.
C147163 LOWER MEDIAL Denoting the lower portion of the body towards the Lower Medial
median plane.
C25232 MEDIAL Toward the middle or in a limb toward the median plane. Medial
C81170 MIDLINE A medial line, especially the medial line or medial plane of Midline
the body (or some part of the body).
C27958 NASAL Of, or related to, or in the direction of the nose. Nasal
C38166 OUTER Being on or toward the outside of the body or object. Outer
(NCI)
C25233 PERIPHERAL On or near an edge or constituting an outer boundary; Peripheral

the outer area. (NCI)
C25622 POSTERIOR Denoting the back portion of the body or a structure. Posterior
C25236 PROXIMAL Situated nearest to a point of reference. Proximal
C147164 PROXIMAL VOLAR Pertaining to the nearest portion from the palm side of a Proximal Volar
hand or the sole side of a foot.
C94393 ROSTRAL Toward the muzzle in the head. Rostral
C25239 SUPERFICIAL Of or pertaining to the exterior surface. (NCI) Superficial
C25235 SUPERIOR Pertaining to a point above a given reference point. Superior
page 354 of 1925

C99074 DIR
Code Value
C25245 SURFACE The extended two-dimensional outer layer or area of a Surface

three-dimensional object. (NCI)
C117754 TEMPORAL Of, or related to, or in the direction of the anatomic sites Temporal Anatomic
that are located in the temple. Qualifier
C90069 TIP The pointed end of a structure. Tip
C25355 UPPER The top one of two. Upper
C147165 UPPER EXTENSOR Pertaining to the upper portion of the surface on the Upper Extensor Surface
SURFACE opposite side of the joint when it bends.
C147166 UPPER FLEXOR SURFACE Pertaining to the upper portion of the surface on the Upper Flexor Surface
same side of the joint when it bends.
C45875 VENTRAL Pertaining to the front or lower surface of the body. Ventral
C98798 VENTROLATERAL Of or pertaining to the front and side of a main body. Ventrolateral
(NCI)
C147167 VOLAR Pertaining to the palm side of a hand or the sole side of a Volar
foot.
page 355 of 1925

DISCHDX (Discharge Disposition)
C101863 DISCHDX
Code Value
C28554 EXPIRED Died The absence of life or state of being dead. (NCI) Dead
C99944 EXPIRED IN A MEDICAL The patient died while in a medical center such as a Died in a Medical Facility
FACILITY hospital, skilled nursing facility (SNF), intermediate care
facility (ICF), or a freestanding hospice center.
C99909 FEDERAL HEALTH CARE The patient will be admitted to a medical center that is Federal Health Care
FACILITY funded by the federal government (e.g. Veterans Affairs Facility
Hospital).
C99959 HOME UNDER CARE OF The patient will return home but personal health Home Under Care of
ORGANIZED HOME maintenance will be administered and monitored by a Organized Home Health
HEALTH SERVICE member of a healthcare organization that is eligible to Service Organization in
ORGANIZATION IN receive Medicare funding. Anticipation of Covered
ANTICIPATION OF Skilled Care
COVERED SKILLED CARE
C99958 HOME, HOSPICE The patient will receive end-of-life care which will be Home Hospice
administered in the patient's home.
C99957 HOME, SELF CARE A routine discharge where personal health maintenance Home Care
will be administered and monitored by the patient from
their home.
C99910 HOSPICE - MEDICAL The patient will receive end-of-life care which will be Hospice Care at Medical
FACILITY administered in a medical center. Facility
C99960 HOSPITAL-BASED The patient will be admitted into a medical center and Hospital with Medicare
MEDICARE-APPROVED receive a type of hospital bed that will be paid for my Approved Swing Bed
SWING BED Medicare.
C99911 INPATIENT The patient will be admitted full time into a free standing Inpatient Rehabilitation
REHABILITATION rehabilitation center or a rehabilitation center within a Facility Including
FACILITY (IRF) general medical facility. Rehabilitation distinct
INCLUDING Part Units of a Hospital
REHABILITATION
DISTINCT PART UNITS OF
A HOSPITAL
C102247 INSTITUTION NOT The patient will be admitted into an alternative facility not Institution Not Defined
DEFINED listed.
C99912 INTERMEDIATE CARE The patient will be admitted into a medical center that Intermediate Care Facility
FACILITY provides care 24 hours per day.
C99969 LEFT AGAINST MEDICAL The patient vacated the medical center or ceased medical Left Against Medical
ADVICE OR care contrary to the recommendation of a trained Advice
DISCONTINUED CARE healthcare provider.
C135382 LONG TERM CARE The patient will be admitted into a hospital equipped and Long Term Care Hospital
HOSPITAL staffed to provide prolonged care to patients.
C99984 MEDICARE-CERTIFIED The patient will be admitted into a Medicare funded Medicare Certified Long
LONG TERM CARE medical center for a considerable length of time. Term Care Hospital
HOSPITAL (LTCH)
C99913 NURSING FACILITY The patient will be admitted into a medical center which Nursing Facility Certified
CERTIFIED UNDER is eligible to receive funding from Medicaid but not Under Medicaid but Not
MEDICAID BUT NOT Medicare. Certified Under Medicare
CERTIFIED UNDER
MEDICARE
C53536 PSYCHIATRIC HOSPITAL The patient will be admitted into a free standing medical Psychiatric Facility
OR A PSYCHIATRIC- facility or a unit within a general medical facility used for
DISTINCT PART UNIT OF the treatment of mental health disorders.
A HOSPITAL
C102248 SHORT TERM GENERAL The patient will remain in a basic hospital environment for Short Term General
HOSPITAL a brief time. Hospital
C99914 SKILLED NURSING The patient will be admitted into a medical center Skilled Nursing Facility
FACILITY (SNF) WITH equipped with a trained nursing staff that is eligible to with Medicare
MEDICARE receive Medicare funding. Certification in
CERTIFICATION IN Anticipation of Covered
ANTICIPATION OF Skilled Care
COVERED SKILLED CARE
page 356 of 1925

DKFATS (Diabetic Kidney Disease Findings About Test Name)
C129939 DKFATS
Code Value
C130057 Number of Events Number of Events The total number of events that have occurred. Number of Events
page 357 of 1925

DKFATSCD (Diabetic Kidney Disease Findings About Test Code)
C129940 DKFATSCD
Code Value
C130057 EVENTNUM Number of Events The total number of events that have occurred. Number of Events
page 358 of 1925

DLQI1TC (Dermatology Life Quality Index Questionnaire Test Code)
C119070 DLQI1TC
Code Value
C119163 DLQI101 DLQI1-How Itchy, Sore, Dermatology Life Quality Index - Over the last week, how DLQI - Itchy, Sore,
Painful, Stinging itchy, sore, painful or stinging has your skin been? Painful or Stinging Skin
C119164 DLQI102 DLQI1-How Embarrassed, Dermatology Life Quality Index - Over the last week, how DLQI - Embarrassed
Self Conscious embarrassed or self conscious have you been because of Because of Skin
your skin?
C119165 DLQI103 DLQI1-Interfered Dermatology Life Quality Index - Over the last week, how DLQI - Skin Interfere
Shopping, Home, Yard much has your skin interfered with you going shopping or With Shopping, Looking
looking after your home or yard? After Home or Yard
C119166 DLQI104 DLQI1-Influenced Clothes Dermatology Life Quality Index - Over the last week, how DLQI - Skin Influence
You Wear much has your skin influenced the clothes you wear? Clothes You Wear
C119167 DLQI105 DLQI1-Affected Social, Dermatology Life Quality Index - Over the last week, how DLQI - Skin Affect Social
Leisure Activity much has your skin affected any social or leisure or Leisure Activities
activities?
C119168 DLQI106 DLQI1-Made It Difficult to Dermatology Life Quality Index - Over the last week, how DLQI - Skin Made Difficult
Do Any Sports much has your skin made it difficult for you to do any to Do Sport
sport?
C119169 DLQI107 DLQI1-Prevented Working Dermatology Life Quality Index - Over the last week, has DLQI - Skin Prevent Work
or Studying your skin prevented you from working or studying? or Study
C119170 DLQI107A DLQI1-Problem at Work Dermatology Life Quality Index - If 'No', over the last DLQI - Skin Has Been a
or Studying week how much has your skin been a problem at work or Problem at Work or Study
studying?
C119171 DLQI108 DLQI1-Problem Partner, Dermatology Life Quality Index - Over the last week, how DLQI - Skin Create
Friends, Relative much has your skin created problems with your partner Problem With Partner,
or any of your close friends or relatives? Friends or Relatives
C119172 DLQI109 DLQI1-Caused Any Dermatology Life Quality Index - Over the last week, how DLQI - Skin Cause Sexual
Sexual Difficulties much has your skin caused any sexual difficulties? Difficulties
C119173 DLQI110 DLQI1-How Much a Dermatology Life Quality Index - Over the last week, how DLQI - Treatment for Skin
Problem is Treatment much of a problem has the treatment for your skin been, Make Home Messy
for example by making your home messy, or by taking up
time?
C119174 DLQI111 DLQI-Score Dermatology Life Quality Index - Score. DLQI - Score
page 359 of 1925

DLQI1TN (Dermatology Life Quality Index Questionnaire Test Name)
C119069 DLQI1TN
Code Value
C119174 DLQI-Score DLQI-Score Dermatology Life Quality Index - Score. DLQI - Score
C119167 DLQI1-Affected Social, DLQI1-Affected Social, Dermatology Life Quality Index - Over the last week, how DLQI - Skin Affect Social
Leisure Activity Leisure Activity much has your skin affected any social or leisure or Leisure Activities
activities?
C119172 DLQI1-Caused Any DLQI1-Caused Any Dermatology Life Quality Index - Over the last week, how DLQI - Skin Cause Sexual
Sexual Difficulties Sexual Difficulties much has your skin caused any sexual difficulties? Difficulties
C119164 DLQI1-How Embarrassed, DLQI1-How Embarrassed, Dermatology Life Quality Index - Over the last week, how DLQI - Embarrassed
Self Conscious Self Conscious embarrassed or self conscious have you been because of Because of Skin
your skin?
C119163 DLQI1-How Itchy, Sore, DLQI1-How Itchy, Sore, Dermatology Life Quality Index - Over the last week, how DLQI - Itchy, Sore,
Painful, Stinging Painful, Stinging itchy, sore, painful or stinging has your skin been? Painful or Stinging Skin
C119173 DLQI1-How Much a DLQI1-How Much a Dermatology Life Quality Index - Over the last week, how DLQI - Treatment for Skin
Problem is Treatment Problem is Treatment much of a problem has the treatment for your skin been, Make Home Messy
for example by making your home messy, or by taking up
time?
C119166 DLQI1-Influenced Clothes DLQI1-Influenced Clothes Dermatology Life Quality Index - Over the last week, how DLQI - Skin Influence
You Wear You Wear much has your skin influenced the clothes you wear? Clothes You Wear
C119165 DLQI1-Interfered DLQI1-Interfered Dermatology Life Quality Index - Over the last week, how DLQI - Skin Interfere
Shopping, Home, Yard Shopping, Home, Yard much has your skin interfered with you going shopping or With Shopping, Looking
looking after your home or yard? After Home or Yard
C119168 DLQI1-Made It Difficult to DLQI1-Made It Difficult to Dermatology Life Quality Index - Over the last week, how DLQI - Skin Made Difficult
Do Any Sports Do Any Sports much has your skin made it difficult for you to do any to Do Sport
sport?
C119169 DLQI1-Prevented Working DLQI1-Prevented Working Dermatology Life Quality Index - Over the last week, has DLQI - Skin Prevent Work
or Studying or Studying your skin prevented you from working or studying? or Study
C119170 DLQI1-Problem at Work DLQI1-Problem at Work Dermatology Life Quality Index - If 'No', over the last DLQI - Skin Has Been a
or Studying or Studying week how much has your skin been a problem at work or Problem at Work or Study
studying?
C119171 DLQI1-Problem Partner, DLQI1-Problem Partner, Dermatology Life Quality Index - Over the last week, how DLQI - Skin Create
Friends, Relative Friends, Relative much has your skin created problems with your partner Problem With Partner,
or any of your close friends or relatives? Friends or Relatives
page 360 of 1925

DMFATS (Duchenne Muscular Dystrophy Findings About Test Name)
C139019 DMFATS
Code Value
C139175 Age at Full-Time Use Age at Full-Time Use The age at which the full-time use of a pre-specified Age at Full-Time Use
object first occurred.
page 361 of 1925

DMFATSCD (Duchenne Muscular Dystrophy Findings About Test Code)
C139018 DMFATSCD
Code Value
C139175 AGEFTUSE Age at Full-Time Use The age at which the full-time use of a pre-specified Age at Full-Time Use
object first occurred.
page 362 of 1925

DOMAIN (SDTM Domain Abbreviation)
C66734 DOMAIN
Code Value
C49563 AD Analysis Dataset A two-letter prefix used to denote ADaM-compliant Analysis Dataset Domain
analysis datasets used for statistical analysis and
reporting by the sponsor. These are submitted in addition
to the data tabulation datasets.
C49562 AE Adverse Events An events domain that contains data describing untoward Adverse Event Domain
medical occurrences in a patient or subjects that are
administered a pharmaceutical product and which may
not necessarily have a causal relationship with the
treatment.
C117755 AG Procedure Agents An interventions domain that contains the agents Procedure Agents Domain
administered to the subject as part of a procedure or
assessment, as opposed to drugs, medications and
therapies administered with therapeutic intent.
C147168 APAE Associated Persons The adverse events domain for those persons associated Associated Persons
Adverse Events with the study itself, a particular study subject, or a Adverse Events Domain
device used in the study.
C147169 APBS Associated Persons The biospecimen domain for those persons associated Associated Persons
Biospecimen with the study itself, a particular study subject, or a Biospecimen Domain
C147170 APDD Associated Persons Death The death details domain for those persons associated Associated Persons Death
Details with the study itself, a particular study subject, or a Details Domain
C132354 APDM Associated Persons The demographics domain for those persons associated Associated Persons
Demographics with the study itself, a particular study subject, or a Demographics
device used in the study. Submission Domain
C147171 APEX Associated Persons The exposure domain for those persons associated with Associated Persons
Exposure the study itself, a particular study subject, or a device Exposure Domain
used in the study.
C147172 APLB Associated Persons The laboratory test results domain for those persons Associated Persons
Laboratory Test Results associated with the study itself, a particular study Laboratory Test Results
subject, or a device used in the study. Domain
C147173 APMH Associated Persons The medical history domain for those persons associated Associated Persons
Medical History with the study itself, a particular study subject, or a Medical History Domain
C147174 APQS Associated Persons The questionnaires domain for those persons associated Associated Persons
Questionnaires with the study itself, a particular study subject, or a Questionnaires Domain
C147175 APRELSUB Relationship between A dataset used to represent relationships between Relationship between
Associated Persons and associated persons (individuals who are not study Associated Persons and
Subjects subjects, but about whom data is collected) and study Subjects Domain
subjects.
C147176 APRP Associated Persons The reproductive system findings domain for those Associated Persons
Reproductive System persons associated with the study itself, a particular Reproductive System
Findings study subject, or a device used in the study. Findings Domain
C147177 APSC Associated Persons The subject characteristics domain for those persons Associated Persons
Subject Characteristics associated with the study itself, a particular study Subject Characteristics
subject, or a device used in the study. Domain
C147178 APSS Associated Persons The subject status domain for those persons associated Associated Persons
Subject Status with the study itself, a particular study subject, or a Subject Status Domain
C147179 APSU Associated Persons The substance use domain for those persons associated Associated Persons
Substance Use with the study itself, a particular study subject, or a Substance Use Domain
C111282 AX Non-Compliant ADaM A two-letter prefix used to denote an analysis dataset Non-Compliant ADaM
Dataset that is not compliant with a defined ADaM structure. Datasets Domain
C111138 BE Biospecimen Events An events domain that documents biospecimen collection Biospecimen Events
and storage information. Domain
C111137 BS Biospecimen Findings A findings domain that documents biospecimen handling Biospecimen Domain
information.
page 363 of 1925

C66734 DOMAIN
Code Value
C85441 CE Clinical Events An events domain that contains clinical events of interest Clinical Events Domain
that would not be classified as adverse events.
C49568 CM Concomitant/Prior An interventions domain that contains concomitant and Concomitant Medication
Medications prior medications used by the subject, such as those Domain
given on an as needed basis or condition-appropriate
medications.
C49569 CO Comments A special-purpose domain that contains comments that Comment Domain
may be collected alongside other data.
C102605 CV Cardiovascular System A findings domain that contains physiological and Cardiovascular System
Findings morphological findings related to the cardiovascular Findings Domain
system, including the heart, blood vessels and lymphatic
vessels.
C49578 DA Drug Accountability A findings domain that contains the accountability of Drug Accountability
study drug, such as information on the receipt, Domain
dispensing, return, and packaging.
C95087 DD Death Details;Death A findings domain that contains the diagnosis of the Death Diagnosis Domain
Diagnosis and Details cause of death for a subject.
C102616 DE Device Events An events domain that contains data for device-related Device Events Domain
events.
C102618 DI Device Identifiers A special-purpose domain containing information that Device Identifiers Domain
identifies a specific device unit.
C49572 DM Demographics A special-purpose domain that includes a set of essential Demographics Domain
standard variables that describe each subject in a clinical
study. It is the parent domain for all other observations
for human clinical subjects.
C102619 DO Device Properties A findings domain that contains the device characteristics Device Properties Domain
that do not vary over the course of the study.
C102620 DR Device-Subject A special-purpose domain that contains the linkage of Device to Subject
Relationships each subject to the device(s) to which they may have Relationship Domain
been exposed during the study.
C49576 DS Disposition An events domain that contains information Disposition Domain

encompassing and representing data related to subject
disposition.
C102621 DT Device Tracking and A events domain that contains the logistics and Device Tracking and
Disposition disposition information specific to a given device. Disposition Domain
C102622 DU Device In-Use A findings domain that contains the measurements and Device-In-Use Domain
settings that are intentionally set on a device when it is in
use. These are characteristics that exist for the device,
and have a specific setting for a use instance.
C49585 DV Protocol Deviations An events domain that contains protocol violations and Protocol Deviations
deviations during the course of the study. Domain
C102617 DX Device Exposure An interventions domain that contains a subject's Device Exposure Domain
exposure to a medical device under study.
C117466 EC Exposure as Collected An interventions domain that contains information about Exposure as Collected
protocol-specified study treatment administrations, as Domain
collected.
C102630 ED Endocrine System A findings domain that contains physiological and Endocrine System
Findings morphological findings related to the endocrine system, Findings Domain
including the glands and cells that make hormones that
are released directly into the blood and travel to tissues
and organs all over the body.
C49626 EG ECG Test Results A findings domain that contains ECG data, including Electrocardiogram
position of the subject, method of evaluation, all cycle Domain
measurements and all findings from the ECG including an
overall interpretation if collected or derived.
C49587 EX Exposure An interventions domain that contains the details of a Exposure Domain
subject's exposure to protocol-specified study treatment.
Study treatment may be any intervention that is
prospectively defined as a test material within a study,
and is typically but not always supplied to the subject.
C85442 FA Findings About Events or A findings domain that contains the findings about an Findings About Events or
Interventions event or intervention that cannot be represented within Interventions Domain
an events or interventions domain record or as a
supplemental qualifier.
page 364 of 1925

C66734 DOMAIN
Code Value
C117756 FT Functional Tests A findings domain that contains data for named, stand- Functional Tests Domain
alone, task-based evaluations designed to provide an
assessment of mobility, dexterity, or cognitive ability.
C102640 GI Gastrointestinal System A findings domain that contains physiological and Digestive System
Findings morphological findings related to the gastrointestinal Findings Domain
system, including the esophagus, stomach, small and
large intestine, anus, liver, biliary tract and pancreas.
C102641 HM Hematopoietic System A findings domain that contains physiological and Hematopoietic System
Findings morphological findings related to the hematopoietic Findings Domain
system, including the bone marrow and lymph nodes
involved in the production of blood.
C117757 HO Healthcare Encounters A events domain that contains data for inpatient and Healthcare Encounters
outpatient healthcare events (e.g., hospitalization, Domain
nursing home stay, rehabilitation facility stay, ambulatory
surgery).
C61536 IE Inclusion/Exclusion A findings domain that contains those criteria that cause Inclusion Exclusion
Criteria Not Met the subject to be in violation of the inclusion/exclusion Criteria Not Met Domain
criteria.
C112320 IS Immunogenicity A findings domain for assessments that determine Immunogenicity

Specimen Assessments whether a therapy induced an immune response. Specimen Assessments
Domain
C49592 LB Laboratory Test Results A findings domain that contains laboratory test data such Laboratory Data Domain
as hematology, clinical chemistry and urinalysis. This
domain does not include microbiology or pharmacokinetic
data, which are stored in separate domains.
C49602 MB Microbiology Specimen A findings domain that represents non-host organisms Microbiology Specimen
identified including bacteria, viruses, parasites, protozoa Domain
and fungi.
C49603 MH Medical History An events domain that contains data that includes the Medical History Domain
subject's prior medical history at the start of the trial.
C95095 MI Microscopic Findings A findings domain that contains histopathology findings Microscopic Findings
and microscopic evaluations. Domain
C102674 MK Musculoskeletal System A findings domain that contains physiological and Musculoskeletal Findings,
Findings morphological findings related to the system of muscles, Connective and Soft
tendons, ligaments, bones, joints, and associated tissues. Tissue Findings Domain
C49604 ML Meal Data An interventions domain that contains information Meal Data Domain
describing a subject's food product consumption.
C61531 MS Microbiology A findings domain that represents drug susceptibility Microbiology

Susceptibility testing results only. This includes phenotypic testing Susceptibility Domain
(where drug is added directly to a culture of organisms)
and genotypic tests that provide results in terms of
susceptible or resistant. Drug susceptibility testing may
occur on a wide variety of non-host organisms, including
bacteria, viruses, fungi, protozoa and parasites.
C102677 NV Nervous System Findings A findings domain that contains physiological and Nervous System Findings
morphological findings related to the nervous system, Domain
including the brain, spinal cord, the cranial and spinal
nerves, autonomic ganglia and plexuses.
C147180 OE Ophthalmic Examinations A findings domain that contains tests that measure a Ophthalmic Examinations
person's ocular health and visual status, to detect Domain
abnormalities in the components of the visual system,
and to determine how well the person can see.
C106552 PB Pharmacogenomics A special-purpose domain that relates a set of genetic Pharmacogenomics

Biomarker variations to an inference about the medical meaning of Biomarker Domain
that set of genetic variations.
C49606 PC Pharmacokinetics A findings domain that contains concentrations of drugs Pharmacokinetic

Concentrations or metabolites in fluids or tissues as a function of time. Concentration Domain
C49608 PE Physical Examination A findings domain that contains findings observed during Physical Exam Domain
a physical examination where the body is evaluated by
inspection, palpation, percussion, and auscultation.
C111289 PF Pharmacogenomics/Genet A findings domain for gene expression and genetic Pharmacogenomics
ics Findings variation assessments. Findings Domain
C61529 PG Pharmacogenomics/Genet A findings domain that contains supporting information Pharmacogenomics

ics Methods and for pharmacogenomics/genetics findings that applies to Domain
Supporting Information the entire test and not an individual findings result.
page 365 of 1925

C66734 DOMAIN
Code Value
C147181 POOLDEF Pool Definition A dataset that identifies individual subjects included in a Pool Definition Dataset
pool of subjects for which a single observation record
(pool level) is captured.
C49607 PP Pharmacokinetic A findings domain that contains pharmacokinetic Pharmacokinetic

Parameters parameters derived from pharmacokinetic concentration- Parameters Domain
time (PC) data.
C102700 PR Procedures An interventions domain that contains interventional Procedure Domain

activity intended to have diagnostic, preventive,
therapeutic, or palliative effects.
C49609 QS Questionnaires A findings domain that contains data for named, stand- Questionnaire Domain
alone instruments designed to provide an assessment of
a concept. Questionnaires have a defined standard
structure, format, and content; consist of conceptually
related items that are typically scored; and have
documented methods for administration and analysis.
C95098 RE Respiratory System A findings domain that contains physiological and Respiratory Domain
Findings morphological findings related to the respiratory system,
including the organs that are involved in breathing such
as the nose, throat, larynx, trachea, bronchi and lungs.
C147182 RELREC Related Records A dataset used to describe relationships between records Related Records Dataset
for a subject within or across domains, and relationships
of records across datasets.
C147183 RELSUB Related Subjects A dataset used to represent relationships between study Related Subjects Dataset
subjects.
C102707 RP Reproductive System A findings domain that contains physiological and Reproductive System
Findings morphological findings related to the male and female Findings Domain
reproductive systems.
C107097 RS Disease Response and A findings domain for the assessment of disease response Disease Response
Clin Classification to therapy, or clinical classification based on published Domain
criteria.
C106571 SB Subject Biomarker A special purpose domain that associates the subject with Subject Biomarker
the medical conclusions contained in the Domain
pharmacogenomics biological state (PB) domain based on
the observations reported in pharmacogenomics findings
(PF) domain.
C49610 SC Subject Characteristics A findings domain that contains subject-related data not Subject Characteristics
collected in other domains. Domain
C49616 SE Subject Elements A special-purpose domain that contains the actual order Subject Element Domain
of elements followed by the subject, together with the
start date/time and end date/time for each element.
C147184 SM Subject Disease A special-purpose domain that is designed to record the Subject Disease
Milestones timing, for each subject, of disease milestones that have Milestones Domain
been defined in the Trial Disease Milestones (TM) domain.
C112420 SR Skin Response A findings about domain for submitting dermal responses Skin Response Domain
to antigens.
C117655 SS Subject Status A findings domain that contains general subject Subject Status Domain
characteristics that are evaluated periodically to
determine if they have changed.
C49615 SU Substance Use An interventions domain that contains substance use Substance Use Domain
information that may be used to assess the efficacy
and/or safety of therapies that look to mitigate the effects
of chronic substance use.
C147185 SUPPAE Supplemental Qualifiers A dataset used to represent non-standard variables and Adverse Events
for Adverse Events their association to parent records in the Adverse Events Supplemental Qualifiers
domain. Dataset
C147186 SUPPAG Supplemental Qualifiers A dataset used to represent non-standard variables and Procedure Agents
for Procedure Agents their association to parent records in the Procedure Supplemental Qualifiers
Agents domain. Dataset
C147187 SUPPBE Supplemental Qualifiers A dataset used to represent non-standard variables and Biospecimen Events
for Biospecimen Events their association to parent records in the Biospecimen Supplemental Qualifiers
Events domain. Dataset
C147188 SUPPBG Supplemental Qualifiers A dataset used to represent non-standard variables and Body Weight Gain
for Body Weight Gain their association to parent records in the Body Weight Supplemental Qualifiers
Gain domain. Dataset
page 366 of 1925

C66734 DOMAIN
Code Value
C147189 SUPPBS Supplemental Qualifiers A dataset used to represent non-standard variables and Biospecimen Findings
for Biospecimen Findings their association to parent records in the Biospecimen Supplemental Qualifiers
Findings domain. Dataset
C147190 SUPPBW Supplemental Qualifiers A dataset used to represent non-standard variables and Body Weight
for Body Weight their association to parent records in the Body Weight Supplemental Qualifiers
domain. Dataset
C147191 SUPPCE Supplemental Qualifiers A dataset used to represent non-standard variables and Clinical Events
for Clinical Events their association to parent records in the Clinical Events Supplemental Qualifiers
domain. Dataset
C147192 SUPPCL Supplemental Qualifiers A dataset used to represent non-standard variables and Clinical Observations
for Clinical Observations their association to parent records in the Clinical Supplemental Qualifiers
Observations domain. Dataset
C147193 SUPPCM Supplemental Qualifiers A dataset used to represent non-standard variables and Concomitant and Prior
for Concomitant/Prior their association to parent records in the Medications Supplemental
Medications Concomitant/Prior Medications domain. Qualifiers Dataset
C147195 SUPPCV Supplemental Qualifiers A dataset used to represent non-standard variables and Cardiovascular System
for Cardiovascular their association to parent records in the Cardiovascular Findings Supplemental
System Findings System Findings (human clinical trials) domain. Qualifiers Dataset
C147196 SUPPDA Supplemental Qualifiers A dataset used to represent non-standard variables and Drug Accountability
for Drug Accountability their association to parent records in the Drug Supplemental Qualifiers
Accountability domain. Dataset
C147197 SUPPDD Supplemental Qualifiers A dataset used to represent non-standard variables and Death Details (human
for Death Details (human their association to parent records in the Death Details clinical trials)
clinical trials) (human clinical trials) domain. Supplemental Qualifiers
Dataset
C147198 SUPPDE Supplemental Qualifiers A dataset used to represent non-standard variables and Device Events
for Device Events their association to parent records in the Device Events Supplemental Qualifiers
domain. Dataset
C147200 SUPPDM Supplemental Qualifiers A dataset used to represent non-standard variables and Demographics
for Demographics their association to parent records in the Demographics Supplemental Qualifiers
domain. Dataset
C147201 SUPPDO Supplemental Qualifiers A dataset used to represent non-standard variables and Device Properties
for Device Properties their association to parent records in the Device Supplemental Qualifiers
Properties domain. Dataset
C147203 SUPPDS Supplemental Qualifiers A dataset used to represent non-standard variables and Disposition Supplemental
for Disposition their association to parent records in the Disposition Qualifiers Dataset
domain.
C147204 SUPPDT Supplemental Qualifiers A dataset used to represent non-standard variables and Device Tracking and
for Device Tracking and their association to parent records in the Device Tracking Disposition Supplemental
Disposition and Disposition domain. Qualifiers Dataset
C147205 SUPPDU Supplemental Qualifiers A dataset used to represent non-standard variables and Device In-Use
for Device In-Use their association to parent records in the Device In-Use Supplemental Qualifiers
domain. Dataset
C147206 SUPPDV Supplemental Qualifiers A dataset used to represent non-standard variables and Protocol Deviations
for Protocol Deviations their association to parent records in the Protocol Supplemental Qualifiers
Deviations domain. Dataset
C147207 SUPPDX Supplemental Qualifiers A dataset used to represent non-standard variables and Device Exposure
for Device Exposure their association to parent records in the Device Exposure Supplemental Qualifiers
domain. Dataset
C147208 SUPPEC Supplemental Qualifiers A dataset used to represent non-standard variables and Exposure as Collected
for Exposure as Collected their association to parent records in the Exposure as Supplemental Qualifiers
Collected domain. Dataset
C147209 SUPPEG Supplemental Qualifiers A dataset used to represent non-standard variables and ECG Test Results
for ECG Test Results their association to parent records in the ECG Test Supplemental Qualifiers
Results domain. Dataset
C147210 SUPPER Supplemental Qualifiers A dataset used to represent non-standard variables and Environmental and Social
for Environmental and their association to parent records in the Environmental Factors Supplemental
Social Factors and Social Factors domain. Qualifiers Dataset
C147211 SUPPEX Supplemental Qualifiers A dataset used to represent non-standard variables and Exposure Supplemental
for Exposure their association to parent records in the Exposure Qualifiers Dataset
domain.
page 367 of 1925

C66734 DOMAIN
Code Value
C147212 SUPPFA Supplemental Qualifiers A dataset used to represent non-standard variables and Findings About Events or
for Findings About Events their association to parent records in the Findings About Interventions
or Interventions Events or Interventions domain. Supplemental Qualifiers
Dataset
C147213 SUPPFM Supplemental Qualifiers A dataset used to represent non-standard variables and Fetal Measurements
for Fetal Measurements their association to parent records in the Fetal Supplemental Qualifiers
Measurements domain. Dataset
C147214 SUPPFW Supplemental Qualifiers A dataset used to represent non-standard variables and Food and Water
for Food and Water their association to parent records in the Food and Water Consumption
Consumption Consumption domain. Supplemental Qualifiers
Dataset
C147215 SUPPFX Supplemental Qualifiers A dataset used to represent non-standard variables and Fetal Pathology Findings
for Fetal Pathology their association to parent records in the Fetal Pathology Supplemental Qualifiers
Findings Findings domain. Dataset
C147216 SUPPHO Supplemental Qualifiers A dataset used to represent non-standard variables and Healthcare Encounters
for Healthcare Encounters their association to parent records in the Healthcare Supplemental Qualifiers
Encounters domain. Dataset
C147217 SUPPIC Supplemental Qualifiers A dataset used to represent non-standard variables and Implantation
for Implantation their association to parent records in the Implantation Classification
Classification Classification domain. Supplemental Qualifiers
Dataset
C147218 SUPPIE Supplemental Qualifiers A dataset used to represent non-standard variables and Inclusion/Exclusion
for Inclusion/Exclusion their association to parent records in the Criteria Not Met
Criteria Not Met Inclusion/Exclusion Criteria Not Met domain. Supplemental Qualifiers
Dataset
C147219 SUPPIS Supplemental Qualifiers A dataset used to represent non-standard variables and Immunogenicity
for Immunogenicity their association to parent records in the Immunogenicity Specimen Assessments
Specimen Assessments Specimen Assessments domain. Supplemental Qualifiers
Dataset
C147220 SUPPLB Supplemental Qualifiers A dataset used to represent non-standard variables and Laboratory Test Results
for Laboratory Test their association to parent records in the Laboratory Test Supplemental Qualifiers
Results Results domain. Dataset
C147221 SUPPMA Supplemental Qualifiers A dataset used to represent non-standard variables and Macroscopic Findings
for Macroscopic Findings their association to parent records in the Macroscopic Supplemental Qualifiers
C147222 SUPPMB Supplemental Qualifiers A dataset used to represent non-standard variables and Microbiology Specimen
for Microbiology their association to parent records in the Microbiology Supplemental Qualifiers
Specimen domain. Dataset
C147223 SUPPMH Supplemental Qualifiers A dataset used to represent non-standard variables and Medical History
for Medical History their association to parent records in the Medical History Supplemental Qualifiers
domain. Dataset
C147224 SUPPMI Supplemental Qualifiers A dataset used to represent non-standard variables and Microscopic Findings
for Microscopic Findings their association to parent records in the Microscopic Supplemental Qualifiers
C147225 SUPPMK Supplemental Qualifiers A dataset used to represent non-standard variables and Musculoskeletal System
for Musculoskeletal their association to parent records in the Musculoskeletal Findings Supplemental
System Findings System Findings domain. Qualifiers Dataset
C147226 SUPPML Supplemental Qualifiers A dataset used to represent non-standard variables and Meal Data Supplemental
for Meal Data their association to parent records in the Meal Data Qualifiers Dataset
domain.
C147227 SUPPMS Supplemental Qualifiers A dataset used to represent non-standard variables and Microbiology
for Microbiology their association to parent records in the Microbiology Susceptibility
Susceptibility Susceptibility domain. Supplemental Qualifiers
Dataset
C147228 SUPPNV Supplemental Qualifiers A dataset used to represent non-standard variables and Nervous System Findings
for Nervous System their association to parent records in the Nervous System Supplemental Qualifiers
C147229 SUPPOE Supplemental Qualifiers A dataset used to represent non-standard variables and Ophthalmic Examinations
for Ophthalmic their association to parent records in the Ophthalmic Supplemental Qualifiers
Examinations Examinations domain. Dataset
C147231 SUPPOM Supplemental Qualifiers A dataset used to represent non-standard variables and Organ Measurements
for Organ Measurements their association to parent records in the Organ Supplemental Qualifiers
Measurements domain. Dataset
page 368 of 1925

C66734 DOMAIN
Code Value
C147232 SUPPPB Supplemental Qualifiers A dataset used to represent non-standard variables and Pharmacogenomics/Genet
for their association to parent records in the ics Biomarker
Pharmacogenomics/Genet Pharmacogenomics/Genetics Biomarker domain. Supplemental Qualifiers
ics Biomarker Dataset
C147233 SUPPPC Supplemental Qualifiers A dataset used to represent non-standard variables and Pharmacokinetics
for Pharmacokinetics their association to parent records in the Concentrations
Concentrations Pharmacokinetics Concentrations domain. Supplemental Qualifiers
Dataset
C147234 SUPPPE Supplemental Qualifiers A dataset used to represent non-standard variables and Physical Examination
for Physical Examination their association to parent records in the Physical Supplemental Qualifiers
Examination domain. Dataset
C147235 SUPPPF Supplemental Qualifiers A dataset used to represent non-standard variables and Pharmacogenomics/Genet
for their association to parent records in the ics Findings Supplemental
Pharmacogenomics/Genet Pharmacogenomics/Genetics Findings domain. Qualifiers Dataset
ics Findings
C147236 SUPPPG Supplemental Qualifiers A dataset used to represent non-standard variables and Pharmacogenomics/Genet
for their association to parent records in the ics Methods and
Pharmacogenomics/Genet Pharmacogenomics/Genetics Methods and Supporting Supporting Information
ics Methods and Information domain. Supplemental Qualifiers
Supporting Information Dataset
C147237 SUPPPM Supplemental Qualifiers A dataset used to represent non-standard variables and Palpable Masses
for Palpable Masses their association to parent records in the Palpable Masses Supplemental Qualifiers
domain. Dataset
C147238 SUPPPP Supplemental Qualifiers A dataset used to represent non-standard variables and Pharmacokinetic
for Pharmacokinetic their association to parent records in the Pharmacokinetic Parameters Supplemental
Parameters Parameters domain. Qualifiers Dataset
C147239 SUPPPR Supplemental Qualifiers A dataset used to represent non-standard variables and Procedures Supplemental
for Procedures their association to parent records in the Procedures Qualifiers Dataset
domain.
C147240 SUPPQS Supplemental Qualifiers A dataset used to represent non-standard variables and Questionnaires
for Questionnaires their association to parent records in the Questionnaires Supplemental Qualifiers
domain. Dataset
C147241 SUPPQT Supplemental Qualifiers A dataset used to represent non-standard variables and ECG QT Correction Model
for ECG QT Correction their association to parent records in the ECG QT Data Supplemental
Model Data Correction Model Data domain. Qualifiers Dataset
C147242 SUPPRE Supplemental Qualifiers A dataset used to represent non-standard variables and Respiratory Test Results
for Respiratory Test their association to parent records in the Respiratory Test Supplemental Qualifiers
Results Results domain. Dataset
C147243 SUPPRP Supplemental Qualifiers A dataset used to represent non-standard variables and Reproductive System
for Reproductive System their association to parent records in the Reproductive Findings Supplemental
Findings System Findings domain. Qualifiers Dataset
C147244 SUPPRS Supplemental Qualifiers A dataset used to represent non-standard variables and Disease Response
for Disease Response their association to parent records in the Disease Supplemental Qualifiers
Response domain. Dataset
C147245 SUPPSB Supplemental Qualifiers A dataset used to represent non-standard variables and Subject Biomarker
for Subject Biomarker their association to parent records in the Subject Supplemental Qualifiers
Biomarker domain. Dataset
C147246 SUPPSC Supplemental Qualifiers A dataset used to represent non-standard variables and Subject Characteristics
for Subject their association to parent records in the Subject Supplemental Qualifiers
Characteristics Characteristics domain. Dataset
C147248 SUPPSJ Supplemental Qualifiers A dataset used to represent non-standard variables and Subject Stages
for Subject Stages their association to parent records in the Subject Stages Supplemental Qualifiers
domain. Dataset
C147249 SUPPSM Supplemental Qualifiers A dataset used to represent non-standard variables and Subject Disease
for Subject Disease their association to parent records in the Subject Disease Milestones Supplemental
Milestones Milestones domain. Qualifiers Dataset
C147250 SUPPSR Supplemental Qualifiers A dataset used to represent non-standard variables and Skin Response
for Skin Response their association to parent records in the Skin Response Supplemental Qualifiers
domain. Dataset
C147251 SUPPSS Supplemental Qualifiers A dataset used to represent non-standard variables and Subject Status
for Subject Status their association to parent records in the Subject Status Supplemental Qualifiers
domain. Dataset
C147252 SUPPSU Supplemental Qualifiers A dataset used to represent non-standard variables and Substance Use
for Substance Use their association to parent records in the Substance Use Supplemental Qualifiers
domain. Dataset
page 369 of 1925

C66734 DOMAIN
Code Value
C147257 SUPPTF Supplemental Qualifiers A dataset used to represent non-standard variables and Tumor Findings
for Tumor Findings their association to parent records in the Tumor Findings Supplemental Qualifiers
domain. Dataset
C147261 SUPPTR Supplemental Qualifiers A dataset used to represent non-standard variables and Tumor Response
for Tumor Response their association to parent records in the Tumor Response Supplemental Qualifiers
domain. Dataset
C147264 SUPPTU Supplemental Qualifiers A dataset used to represent non-standard variables and Tumor/Lesion
for Tumor/Lesion their association to parent records in the Tumor/Lesion Identification
Identification Identification domain. Supplemental Qualifiers
Dataset
C147267 SUPPUR Supplemental Qualifiers A dataset used to represent non-standard variables and Urinary System Findings
for Urinary System their association to parent records in the Urinary System Supplemental Qualifiers
C147268 SUPPVS Supplemental Qualifiers A dataset used to represent non-standard variables and Vital Signs Supplemental
for Vital Signs their association to parent records in the Vital Signs Qualifiers Dataset
domain.
C147269 SUPPWB Supplemental Qualifiers A dataset used to represent non-standard variables and Whole Body Findings
for Whole Body Findings their association to parent records in the Whole Body Supplemental Qualifiers
C49617 SV Subject Visits A special-purpose domain that contains the actual start Subject Visits Domain
and end data/time for each visit of each individual
subject.
C49618 TA Trial Arms A trial design domain that contains each planned arm in Trial Arms Domain
the trial.
C117699 TD Trial Disease A trial design domain that provides information on the Trial Disease
Assessments protocol-specified disease assessment schedule, to be Assessments Domain
used for comparison with the actual occurrence of the
efficacy assessments in order to determine whether there
was good compliance with the schedule.
C49619 TE Trial Elements A trial design domain that contains the element code that Trial Elements Domain
is unique for each element, the element description, and
the rules for starting and ending an element.
C49620 TI Trial Inclusion/Exclusion A trial design domain that contains one record for each of Trial Inclusion and
Criteria the inclusion and exclusion criteria for the trial. This Exclusion Criteria Domain
domain is not subject oriented.
C147270 TM Trial Disease Milestones A trial design domain that is used to describe disease Trial Disease Milestones
milestones, which are observations or activities Domain
anticipated to occur in the course of the disease under
study, and which trigger the collection of data.
C106578 TR Tumor/Lesion Results A findings domain that represents quantitative Tumor Results Domain
measurements and/or qualitative assessments of the
tumors or lesions identified in the tumor/lesion
identification (TU) domain.
C53483 TS Trial Summary A trial design domain that contains one record for each Trial Summary Domain
trial summary characteristic. This domain is not subject
oriented.
C106577 TU Tumor/Lesion A findings domain that represents data that uniquely Tumor Identifier Domain
Identification identifies tumors or lesions under study.
C49621 TV Trial Visits A trial design domain that contains the planned order and Trial Visits Domain
number of visits in the study within each arm.
C95103 TX Trial Sets A trial design domain that contains one record for each Trial Sets Domain
trial set characteristic including experimental factors,
treatment factors, inherent characteristics, or distinct
sponsor designations. This domain is not subject
oriented.
C102726 UR Urinary System Findings A findings domain that contains physiological and Urinary System Findings
morphological findings related to the urinary tract, Domain
including the organs involved in the creation and
excretion of urine such as the kidneys, ureters, bladder
and urethra.
C49622 VS Vital Signs A findings domain that contains measurements including Vital Signs Domain
but not limited to blood pressure, temperature,
respiration, body surface area, body mass index, height
and weight.
page 370 of 1925

DOTEST (Device Properties Test Name)
C111112 DOTEST
Code Value
C53414 Composition Composition The materials from which something is made. Composition
C142234 Digital Sampling Rate Digital Sampling Rate The number of digital samples taken or recorded per unit Digital Sampling Rate
of time.
C154712 Dinucleotide Marker Dinucleotide Marker The literal identifier of the dinucleotide markers present Dinucleotide Marker
Names Names in an assay kit. Name
C142235 Electrical Current Sensor Electrical Current Sensor A description of the sensor used to detect electrical Type of Electrical Current
Type Type current. Sensor
C112278 FDA Device Classification FDA Device Classification The class of medical device as determined by the US Food FDA Device Classification
and Drug Administration, based upon the level of control
necessary to ensure safety and effectiveness (21 CFR
860).
C41184 Indication for Use Indication for Use A general description of the disease or condition the Indication
product will diagnose, treat, prevent, cure, or mitigate.
C154711 Internal Orifice Area Internal Orifice Area The extent of a 2-dimensional surface enclosed within the Internal Orifice Area
boundary of an internal orifice.
C120606 Luminescence Type Luminescence Type A classification of light emission. Luminescence Type
C150830 Mononucleotide Marker Mononucleotide Marker The literal identifier of the mononucleotide markers Mononucleotide Marker
Names Names present in an assay kit. Name
C116119 MRI Coil Type MRI Coil Type The classification of the coil that is used in an magnetic MRI Coil Type
resonance imaging procedure. Usually refers to the
anatomical location for where the coil is placed such as
head, body or breast.
C116118 Multiplex Probe Multiplex Probe A descriptor referring to the number of unique molecular Multiplex Probe
Parameter Parameter probes contained in each assay component from which Parameter
results are obtained, such as each well in a 96-well plate.
C150831 Pentanucleotide Marker Pentanucleotide Marker The literal identifier of the pentanucleotide markers Pentanucleotide Marker
Names Names present in an assay kit. Name
C112332 Pore Size Pore Size A quantitative or qualitative measurement of the physical Material Pore Size
dimensions of the pores in a material.
C112406 Reagent Lot Reagent Lot The lot number of the reagent. Reagent Lot Number
C116120 Scintillation Crystal Type Scintillation Crystal Type The classification of the crystalline material, which emits Scintillation Crystal Type
light in response to radiation exposure, used in the
imaging procedure.
C70855 Shelf Life Shelf Life The period during which a medical product retains its Medical Product Shelf Life
properties and stated performance within specified limits
if stored under defined conditions. The stability period is
determined from the date the product was manufactured.
C25681 Size Size The physical magnitude of something. (NCI) Size
C150832 Software Name Software Name The literal identifier of the software program. Software Name
C111093 Software Version Software Version A form or variant of software; one of a sequence of Software Version
copies of a software program, each incorporating new
modifications. (NCI)
C112421 Surgical Mesh Open Area Surgical Mesh Open Area A quantitative or qualitative measurement of the physical Surgical Mesh Open Area
dimensions of the open spaces in a loosely woven sheet
of inorganic or biological materials, which is used to
physically support organs or tissue during a surgical
procedure.
C25206 Temperature Temperature The property of a body or region of space that determines Temperature
page 371 of 1925

C111112 DOTEST
Code Value
C41145 Thickness Thickness The dimension between two surfaces of an object, usually Thickness
length.
page 372 of 1925

DOTESTCD (Device Properties Test Code)
C111111 DOTESTCD
Code Value
C53414 COMPOS Composition The materials from which something is made. Composition
C142234 DIGSMPRT Digital Sampling Rate The number of digital samples taken or recorded per unit Digital Sampling Rate
of time.
C154712 DINTMKNM Dinucleotide Marker The literal identifier of the dinucleotide markers present Dinucleotide Marker
Names in an assay kit. Name
C142235 ECSNRTYP Electrical Current Sensor A description of the sensor used to detect electrical Type of Electrical Current
Type current. Sensor
C112278 FDADEVCL FDA Device Classification The class of medical device as determined by the US Food FDA Device Classification
and Drug Administration, based upon the level of control
necessary to ensure safety and effectiveness (21 CFR
860).
C41184 INDC Indication for Use A general description of the disease or condition the Indication
product will diagnose, treat, prevent, cure, or mitigate.
C154711 IORFAREA Internal Orifice Area The extent of a 2-dimensional surface enclosed within the Internal Orifice Area
boundary of an internal orifice.
C120606 LUMNCTYP Luminescence Type A classification of light emission. Luminescence Type
C150830 MONTMKNM Mononucleotide Marker The literal identifier of the mononucleotide markers Mononucleotide Marker
Names present in an assay kit. Name
C116119 MRICTYPE MRI Coil Type The classification of the coil that is used in an magnetic MRI Coil Type
resonance imaging procedure. Usually refers to the
anatomical location for where the coil is placed such as
head, body or breast.
C116118 MULTPLEX Multiplex Probe A descriptor referring to the number of unique molecular Multiplex Probe
Parameter probes contained in each assay component from which Parameter
results are obtained, such as each well in a 96-well plate.
C150831 PENTMKNM Pentanucleotide Marker The literal identifier of the pentanucleotide markers Pentanucleotide Marker
Names present in an assay kit. Name
C112332 PORESIZE Pore Size A quantitative or qualitative measurement of the physical Material Pore Size
dimensions of the pores in a material.
C112406 REAGLOT Reagent Lot The lot number of the reagent. Reagent Lot Number
C116120 SCRYSTYP Scintillation Crystal Type The classification of the crystalline material, which emits Scintillation Crystal Type
light in response to radiation exposure, used in the
imaging procedure.
C150832 SFTWRNAM Software Name The literal identifier of the software program. Software Name
C111093 SFTWRVER Software Version A form or variant of software; one of a sequence of Software Version
C70855 SHLFLIFE Shelf Life The period during which a medical product retains its Medical Product Shelf Life
properties and stated performance within specified limits
if stored under defined conditions. The stability period is
determined from the date the product was manufactured.
C25681 SIZE Size The physical magnitude of something. (NCI) Size
C112421 SRGMSHOA Surgical Mesh Open Area A quantitative or qualitative measurement of the physical Surgical Mesh Open Area
dimensions of the open spaces in a loosely woven sheet
of inorganic or biological materials, which is used to
physically support organs or tissue during a surgical
procedure.
C25206 TEMP Temperature The property of a body or region of space that determines Temperature
page 373 of 1925

C111111 DOTESTCD
Code Value
C41145 THICKNSS Thickness The dimension between two surfaces of an object, usually Thickness
length.
page 374 of 1925

DRRI1TC (Deployment Risk and Resilience Inventory-2 Questionnaire Test Code)
C141673 DRRI1TC
Code Value
C141867 DRRI1A01 DRRI1-A: Someone Close Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Someone
to Me Died deployment: someone close to me died. Close to Me Died
C141868 DRRI1A02 DRRI1-A: Went Through Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Went
Divorce/Was Left deployment: I went through a divorce or was left by a Through Divorce/Was Left
significant other.
C141869 DRRI1A03 DRRI1-A: Robbed/Had My Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Robbed/Had
Home Broken Into deployment: I was robbed or had my home broken into. My Home Broken Into
C141870 DRRI1A04 DRRI1-A: Saw/Heard Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Saw/Heard
Physical Fight Parent deployment: I saw or heard physical fighting between my Physical Fight Parent
parents or caregivers.
C141871 DRRI1A05 DRRI1-A: Physically Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Physically
Punished by Parent deployment: I was physically punished by a parent or Punished by Parent
primary caregiver.
C141872 DRRI1A06 DRRI1-A: Unwanted Sex Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Unwanted
Activity Childhood deployment: I experienced unwanted sexual activity as a Sex Activity Childhood
result of force, threat of harm, or manipulation during
childhood (before age 18).
C141873 DRRI1A07 DRRI1-A: Unwanted Sex Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Unwanted
Activity Adulthood deployment: I experienced unwanted sexual activity as a Sex Activity Adulthood
adulthood (age 18 or later).
C141874 DRRI1A08 DRRI1-A: Experienced Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Experienced
Natural Disaster deployment: I experienced a natural disaster (for Natural Disaster
example, a hurricane), a fire, or an accident in which I or
someone close to me was hurt or had serious property
damage.
C141875 DRRI1A09 DRRI1-A: Someone Close Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Someone
Serious Illness deployment: someone close to me experienced a serious Close Serious Illness
illness, injury, or mental health problem (for example,
cancer, alcohol/drug problem).
C141876 DRRI1A10 DRRI1-A: Witnessed Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Witnessed
Someone Assaulted deployment: I witnessed someone being seriously Someone Assaulted
assaulted or killed.
C141877 DRRI1A11 DRRI1-A: Lost My Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Lost My
Job/Trouble Finding Job deployment: I lost my job or had serious trouble finding a Job/Trouble Finding Job
job.
C141878 DRRI1A12 DRRI1-A: Emotionally Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Emotionally
Mistreated deployment: I was emotionally mistreated (for example, Mistreated
ignored or repeatedly told I was no good).
C141879 DRRI1A13 DRRI1-A: Serious Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Serious
Financial Problems deployment: I experienced serious financial problems. Financial Problems
C141880 DRRI1A14 DRRI1-A: Serious Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Serious
Physical Health Problem deployment: I experienced serious physical or mental Physical Health Problem
health problems.
C141881 DRRI1A15 DRRI1-A: Dangerous Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Dangerous
Military Duties deployment: I participated in dangerous military duties. Military Duties
C141882 DRRI1A16 DRRI1-A: Injured by Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Injured by
Person - Childhood deployment: I was seriously physically injured by another Person - Childhood
person (for example, hit or beaten up) during childhood
(before age 18).
C141883 DRRI1A17 DRRI1-A: Injured by Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Injured by
Person - Adulthood deployment: I was seriously physically injured by another Person - Adulthood
person (for example, hit or beaten up) during adulthood
(age 18 or later).
C141884 DRRI1A18 DRRI1-A: Stressful Legal Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Stressful
Problems deployment: I experienced stressful legal problems (for Legal Problems
example, being sued, suing someone else, or being in a
custody battle).
C141885 DRRI1B01 DRRI1-B: Got Along Well Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Got Along
With My Family childhood: I got along well with my family members. Well With My Family
page 375 of 1925

C141673 DRRI1TC
Code Value
C141886 DRRI1B02 DRRI1-B: Felt Like I Fit in Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Felt Like I Fit
With Family childhood: I felt like I fit in with my family. in With Family
C141887 DRRI1B03 DRRI1-B: Family Knew Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Family Knew
What I Thought/Felt childhood: family members knew what I thought and how What I Thought/Felt
I felt about things.
C141888 DRRI1B04 DRRI1-B: Contribution Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Contribution
Family Appreciated childhood: I felt like my contributions to my family were Family Appreciated
appreciated.
C141889 DRRI1B05 DRRI1-B: Shared Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Shared
Interests With Family childhood: I shared many common interests and activities Interests With Family
with family members.
C141890 DRRI1B06 DRRI1-B: Opinions Were Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Opinions
Valued by Family childhood: my opinions were valued by other family Were Valued by Family
members.
C141891 DRRI1B07 DRRI1-B: I Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: I Was
Affectionate With Family childhood: I was affectionate with family members. Affectionate With Family
C141892 DRRI1B08 DRRI1-B: Played Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Played
Important Role in Family childhood: I played an important role in my family. Important Role in Family
C141893 DRRI1B09 DRRI1-B: Spent My Free Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Spent My
Time With Family childhood: I spent as much of my free time with family Free Time With Family
members as possible.
C141894 DRRI1B10 DRRI1-B: Family Told Me Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Family Told
When Problem childhood: family members told me when they were Me When Problem
having a problem.
C141895 DRRI1B11 DRRI1-B: I Could Be Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: I Could Be
Myself Around Family childhood: I could be myself around family members. Myself Around Family
C141896 DRRI1B12 DRRI1-B: Input Sought Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Input Sought
Family Decisions childhood: my input was sought on important family Family Decisions
decisions.
C141897 DRRI1C01 DRRI1-C: Climate Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Climate Was
Uncomfortable deployment: the climate was uncomfortable. Uncomfortable
C141898 DRRI1C02 DRRI1-C: Deal With Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Deal With
Annoying Animals deployment: I had to deal with annoying animals, insects, Annoying Animals
or plants.
C141899 DRRI1C03 DRRI1-C: Food Was of Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Food Was of
Very Poor Quality deployment: the food I had to eat was of very poor Very Poor Quality
quality (for example, bad or old MREs).
C141900 DRRI1C04 DRRI1-C: Conditions Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Conditions
Extremely Unsanitary deployment: the conditions I lived in were extremely Extremely Unsanitary
unsanitary.
C141901 DRRI1C05 DRRI1-C: Didn't Have Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Didn't Have
Bathrooms deployment: I didn't have access to bathrooms or Bathrooms
showers when I needed them.
C141902 DRRI1C06 DRRI1-C: Wasn't Able to Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Wasn't Able
Get Privacy deployment: I wasn't able to get as much privacy as I to Get Privacy
needed.
C141903 DRRI1C07 DRRI1-C: I Was Exposed Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: I Was
to Awful Smells deployment: I was exposed to awful smells. Exposed to Awful Smells
C141904 DRRI1C08 DRRI1-C: I Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: I Was
Subjected to Loud Noises deployment: I was subjected to loud noises. Subjected to Loud Noises
C141905 DRRI1C09 DRRI1-C: Restricted Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Restricted
Because Local Custom deployment: my daily activities were restricted because Because Local Custom
of local religious or ethnic customs.
Rest deployment: I wasn't able to get rest when I needed it. to Rest
Contact Home deployment: I wasn't able to contact home when I to Contact Home
needed to.
C141908 DRRI1C12 DRRI1-C: Hassle With Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Hassle With
Heavy/Annoying Gear deployment: I had to hassle with putting on and taking Heavy/Annoying Gear
off heavy or annoying gear.
page 376 of 1925

C141673 DRRI1TC
Code Value
C141909 DRRI1C13 DRRI1-C: Not Allowed to Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Not Allowed
Get Job Done deployment: I was not allowed to do the things I needed to Get Job Done
to do to get my job done.
C141910 DRRI1C14 DRRI1-C: Not Have Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Not Have
Adequate Shelter deployment: I did not have adequate shelter from Adequate Shelter
uncomfortable living conditions (for example, heat, cold,
wet, etc.).
C141911 DRRI1D01 DRRI1-D: Went on Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Went on
Combat Patrols/Missions deployment: I went on combat patrols or missions. Combat Patrols/Missions
C141912 DRRI1D02 DRRI1-D: Assault on Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Assault on
Entrenched Positions deployment: I took part in an assault on entrenched or Entrenched Positions
fortified positions that involved naval and/or land forces.
C141913 DRRI1D03 DRRI1-D: Witnessed Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Witnessed
Someone Unit Wounded deployment: I personally witnessed someone from my Someone Unit Wounded
unit or an ally unit being seriously wounded or killed.
C141914 DRRI1D04 DRRI1-D: Encountered Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Encountered
Land Mines deployment: I encountered land or water mines, booby Land Mines
traps, or roadside bombs (for example, IEDs).
C141915 DRRI1D05 DRRI1-D: Exposed Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Exposed
Hostile Incoming Fire deployment: I was exposed to hostile incoming fire. Hostile Incoming Fire
C141916 DRRI1D06 DRRI1-D: Exposed to Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Exposed to
Friendly Fire deployment: I was exposed to "friendly" fire. Friendly Fire
C141917 DRRI1D07 DRRI1-D: Vehicle/Part of Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Vehicle/Part
Convoy Attacked deployment: I was in a vehicle (for example, a "humvee", of Convoy Attacked
helicopter, or boat) or part of a convoy that was attacked.
C141918 DRRI1D08 DRRI1-D: Part of Unit Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Part of Unit
Fired on Enemy deployment: I was part of a land or naval artillery unit Fired on Enemy
that fired on enemy combatants.
Enemy Wounded/Killed deployment: I personally witnessed enemy combatants Enemy Wounded/Killed
being seriously wounded or killed.
Civilians Wounded deployment: I personally witnessed civilians (for Civilians Wounded
example, women and children) being seriously wounded
or killed.
C141921 DRRI1D11 DRRI1-D: Injured Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Injured
Combat-Related Incident deployment: I was injured in a combat-related incident. Combat-Related Incident
C141922 DRRI1D12 DRRI1-D: Fired My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Fired My
Weapon Enemy deployment: I fired my weapon at enemy combatants. Weapon Enemy
Combatant Combatant
C141923 DRRI1D13 DRRI1-D: Think I Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Think I
Wounded/Killed Someone deployment: I think I wounded or killed someone during Wounded/Killed Someone
combat operations.
C141924 DRRI1D14 DRRI1-D: Locating Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Locating
Explosive Devices deployment: I was involved in locating or disarming Explosive Devices
explosive devices.
C141925 DRRI1D15 DRRI1-D: Searching Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Searching
Homes/Buildings deployment: I was involved in searching or clearing Homes/Buildings
homes, buildings, or other locations.
C141926 DRRI1D16 DRRI1-D: Participate Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Participate
Hand-to-hand Combat deployment: I participated in hand-to-hand combat. Hand-to-hand Combat
C141927 DRRI1D17 DRRI1-D: Search/Disarm Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D:
Potential Enemy deployment: I was involved in searching and/or Search/Disarm Potential
disarming potential enemy combatants. Enemy
C141928 DRRI1E01 DRRI1-E: Saw People Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw People
Begging for Food deployment: I saw people begging for food. Begging for Food
C141929 DRRI1E02 DRRI1-E: Saw Refugees Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw
Who Had Lost Homes deployment: I saw refugees who had lost their homes or Refugees Who Had Lost
belongings. Homes
C141930 DRRI1E03 DRRI1-E: Observed Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Observed
Homes Been Destroyed deployment: I observed homes or communities that had Homes Been Destroyed
been destroyed.
page 377 of 1925

C141673 DRRI1TC
Code Value
C141931 DRRI1E04 DRRI1-E: Took Care Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Took Care
Injured/Dying People deployment: I took care of injured or dying people. Injured/Dying People
C141932 DRRI1E05 DRRI1-E: Saw Civilians Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw Civilians
After Wounded deployment: I saw civilians after they had been severely After Wounded
wounded or disfigured.
C141933 DRRI1E06 DRRI1-E: Saw Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw
Combatants Had Been deployment: I saw enemy combatants after they had Combatants Had Been
Wounded been severely wounded or disfigured. Wounded
C141934 DRRI1E07 DRRI1-E: Saw Americans Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw
Had Been Wounded deployment: I saw Americans or allies after they had Americans Had Been
been severely wounded or disfigured. Wounded
C141935 DRRI1E08 DRRI1-E: Saw Bodies of Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw Bodies
Dead Enemy deployment: I saw the bodies of dead enemy of Dead Enemy
combatants.
Dead Americans deployment: I saw the bodies of dead Americans or allies. of Dead Americans
Dead Civilians deployment: I saw the bodies of dead civilians. of Dead Civilians
C141938 DRRI1E11 DRRI1-E: Interacted With Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Interacted
Detainees deployment: I interacted with detainees or prisoners of With Detainees
war.
C141939 DRRI1E12 DRRI1-E: Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E:
Sight/Sound/Smell Dead deployment: I was exposed to the sight, sound, or smell Sight/Sound/Smell Dead
Animals of dead or dying animals. Animals
C141940 DRRI1E13 DRRI1-E: Involved Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Involved
Handling Human Remains deployment: I was involved in handling human remains. Handling Human Remains
C141941 DRRI1F01 DRRI1-F: Took Deployment Risk & Resilience Inventory-2 - Either in DRRI-2 - F: Took
Preventative Pills preparation for or during my deployment: I took Preventative Pills
preventative pills (for example, to protect against nerve
gas).
C141942 DRRI1F02 DRRI1-F: Received Deployment Risk & Resilience Inventory-2 - Either in DRRI-2 - F: Received
Vaccinations preparation for or during my deployment: I received Vaccinations
preventative vaccinations by injection (for example, to
prevent anthrax or botulism).
C141943 DRRI1F03 DRRI1-F: Exposed to Deployment Risk & Resilience Inventory-2 - Either in DRRI-2 - F: Exposed to
Nerve Gas Agents preparation for or during my deployment: I was exposed Nerve Gas Agents
to nerve gas agents (for example, sarin).
Mustard Gas preparation for or during my deployment: I was exposed Mustard Gas
to mustard gas or other blistering agents.
C141945 DRRI1F05 DRRI1-F: Exposed Deployment Risk & Resilience Inventory-2 - Either in DRRI-2 - F: Exposed
Government-issued DEET preparation for or during my deployment: I was exposed Government-issued DEET
to government-issued DEET-containing insect repellents.
Other Pesticides preparation for or during my deployment: I was exposed Other Pesticides
to other pesticides (for example, in flea collars, uniforms,
or the environment).
Smoke/Air Pollution preparation for or during my deployment: I was exposed Smoke/Air Pollution
to smoke or other air pollution.
Diesel/Fuel on Skin preparation for or during my deployment: I was exposed Diesel/Fuel on Skin
to diesel or other petrochemical fuel on my skin.
Fumes From Heaters preparation for or during my deployment: I was exposed Fumes From Heaters
to fumes or exhaust from heaters or generators, including
heaters in tents.
Depleted Uranium preparation for or during my deployment: I was exposed Depleted Uranium
to depleted uranium in munitions.
Burning Trash/Feces preparation for or during my deployment: I was exposed Burning Trash/Feces
to burning trash or burning feces.
page 378 of 1925

C141673 DRRI1TC
Code Value
Chlorine Gas preparation for or during my deployment: I was exposed Chlorine Gas
to chlorine gas.
Nuclear Weapons preparation for or during my deployment: I was exposed Nuclear Weapons
to nuclear, biological, or chemical weapons.
C141954 DRRI1G01 DRRI1-G: Concerned Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Concerned
Infectious Disease deployment: I was concerned about getting an infectious Infectious Disease
disease.
C141955 DRRI1G02 DRRI1-G: Health Might Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Health Might
Suffer NBC Agents deployment: I was concerned that my health might suffer Suffer NBC Agents
due to exposure to nuclear, biological, or chemical (NBC)
agents.
C141956 DRRI1G03 DRRI1-G: Felt in Danger Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Felt in
of Being Wounded deployment: I felt I was in great danger of being Danger of Being Wounded
wounded (for example, losing a limb).
Medicine Make Me Sick deployment: I was concerned that the medicine I was Medicine Make Me Sick
given to protect me from illness would make me sick.
Encounter Explosive deployment: I was concerned that I would encounter an Encounter Explosive
explosive device (for example, a roadside bomb, mine, or
booby trap).
C141959 DRRI1G06 DRRI1-G: Feared Sick Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Feared Sick
From Pesticides deployment: I feared that I would become sick from From Pesticides
pesticides (for example, bug spray) or other routinely
used chemicals.
C141960 DRRI1G07 DRRI1-G: Concern Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Concern
Rocket/Mortar Would Hit deployment: I was concerned that a rocket or mortar Rocket/Mortar Would Hit
would hit our living quarters.
Depleted Uranium deployment: I was concerned that I might be exposed to Depleted Uranium
depleted uranium in munitions.
C141962 DRRI1G09 DRRI1-G: Thought I Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Thought I
Would Never Survive deployment: I thought I would never survive. Would Never Survive
Taken Hostage deployment: I was concerned that I might be taken Taken Hostage
hostage.
Locals Against Us deployment: I was concerned that the locals who were Locals Against Us
supposed to be helping us were actually working against
us.
Trapped in Crossfire deployment: I was concerned about being trapped in the Trapped in Crossfire
crossfire of rival factions.
C141966 DRRI1H01 DRRI1-H: Had All Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Had All
Supplies Needed preparation for deployment: I had all the supplies and Supplies Needed
equipment needed to get my job done.
C141967 DRRI1H02 DRRI1-H: Confident Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Confident
Ability Use Equipment preparation for deployment: the training I received made Ability Use Equipment
me feel confident in my ability to use my equipment.
C141968 DRRI1H03 DRRI1-H: Prepared to Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Prepared to
Deal With Climate preparation for deployment: the training I received Deal With Climate
prepared me to deal with the region's climate.
C141969 DRRI1H04 DRRI1-H: Accurately Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Accurately
Informed About Role preparation for deployment: I was accurately informed Informed About Role
about the role my unit was expected to play in the
deployment.
C141970 DRRI1H05 DRRI1-H: Had Enough Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Had Enough
Gear in Case Attack preparation for deployment: I had enough gear to protect Gear in Case Attack
myself in case of an attack.
C141971 DRRI1H06 DRRI1-H: Training for Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Training for
Deployment preparation for deployment: I received appropriate Deployment
training for the nature of the deployment I experienced.
page 379 of 1925

C141673 DRRI1TC
Code Value
C141972 DRRI1H07 DRRI1-H: Military Duties Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Military
What I Expected preparation for deployment: my military duties and Duties What I Expected
assignments were what I expected.
C141973 DRRI1H08 DRRI1-H: Prepared to Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Prepared to
Operate as Team preparation for deployment: my unit was well-prepared Operate as Team
to operate as a team during deployment.
C141974 DRRI1H09 DRRI1-H: Confident to Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Confident to
Perform Tasks preparation for deployment: the training I received made Perform Tasks
me feel confident in my ability to perform tasks assigned
to me during deployment.
C141975 DRRI1H10 DRRI1-H: Taught Me Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Taught Me
Everything I Needed preparation for deployment: the training I received Everything I Needed
taught me everything I needed to know for deployment.
C141976 DRRI1I01 DRRI1-I: Family Sincerely Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Family
Interested deployment: family members and/or friends at home Sincerely Interested
were sincerely interested in hearing what was going on
with me.
C141977 DRRI1I02 DRRI1-I: Had Family I Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Had Family I
Could Talk To deployment: I had family members or friends at home I Could Talk To
could talk to when I had a problem.
C141978 DRRI1I03 DRRI1-I: Could Count on Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Could Count
Family Advice deployment: I could count on my family members or on Family Advice
friends at home for good advice.
C141979 DRRI1I04 DRRI1-I: Relatives Look Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Relatives
Out for Family deployment: relatives or friends at home could be Look Out for Family
counted on to look out for the well-being of my family or
other dependents (including pets).
C141980 DRRI1I05 DRRI1-I: Relatives Take Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Relatives
Care of Finances deployment: relatives or friends at home could be Take Care of Finances
counted on to take care of my finances, property, or
belongings if needed.
C141981 DRRI1I06 DRRI1-I: Happy Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Happy
Communication From deployment: I was happy with the amount of Communication From
Home communication I received from people at home. Home
C141982 DRRI1I07 DRRI1-I: Happy With Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Happy With
Support From Home deployment: I was happy with the amount of support I Support From Home
received from people at home.
C141983 DRRI1I08 DRRI1-I: People at Home Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: People at
Show They Cared deployment: people at home did things to show they Home Show They Cared
cared about me.
C141984 DRRI1J01 DRRI1-J: My Unit Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: My Unit Was
Like Family to Me deployment: my unit was like family to me. Like Family to Me
C141985 DRRI1J02 DRRI1-J: People in Unit Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: People in Unit
Were Trustworthy deployment: people in my unit were trustworthy. Were Trustworthy
C141986 DRRI1J03 DRRI1-J: Fellow Unit Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Fellow Unit
Appreciated Efforts deployment: my fellow unit members appreciated my Appreciated Efforts
efforts.
C141987 DRRI1J04 DRRI1-J: Felt Valued Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Felt Valued
Fellow Unit Members deployment: I felt valued by my fellow unit members. Fellow Unit Members
C141988 DRRI1J05 DRRI1-J: Unit Interested Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Unit
My Well-being deployment: members of my unit were interested in my Interested My Well-being
well-being.
C141989 DRRI1J06 DRRI1-J: Unit Interested Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Unit
What I Thought deployment: my fellow unit members were interested in Interested What I
what I thought and how I felt about things. Thought
C141990 DRRI1J07 DRRI1-J: Leader Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Leader
Interested What Thought deployment: my unit leader(s) were interested in what I Interested What Thought
thought and how I felt about things.
C141991 DRRI1J08 DRRI1-J: Felt Like My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Felt Like My
Efforts Counted deployment: I felt like my efforts really counted to the Efforts Counted
leaders in my unit.
C141992 DRRI1J09 DRRI1-J: Service Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Service
Appreciated by Leaders deployment: my service was appreciated by the leaders Appreciated by Leaders
in my unit.
page 380 of 1925

C141673 DRRI1TC
Code Value
C141993 DRRI1J10 DRRI1-J: Could Go to Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Could Go to
Leaders If Problem deployment: I could go to unit leaders for help if I had a Leaders If Problem
problem or concern.
C141994 DRRI1J11 DRRI1-J: Leaders Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Leaders
Interested in Welfare deployment: the leaders of my unit were interested in my Interested in Welfare
personal welfare.
C141995 DRRI1J12 DRRI1-J: Felt Valued by Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Felt Valued
Leaders of Unit deployment: I felt valued by the leaders of my unit. by Leaders of Unit
C141996 DRRI1K01 DRRI1-K: Treated in Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Treated in
Overly Critical Way deployment, the people I worked with: treated me in an Overly Critical Way
overly critical way.
C141997 DRRI1K02 DRRI1-K: Uncooperative Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K:
Working With Me deployment, the people I worked with: behaved in way Uncooperative Working
that was uncooperative when working with me. With Me
C141998 DRRI1K03 DRRI1-K: Had to Work Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Had to Work
Harder Prove Myself deployment, the people I worked with: treated me as if I Harder Prove Myself
had to work harder than others to prove myself.
C141999 DRRI1K04 DRRI1-K: Questioned My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Questioned
Abilities Perform deployment, the people I worked with: questioned my My Abilities Perform
abilities or commitment to perform my job effectively.
C142000 DRRI1K05 DRRI1-K: My Mistakes Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: My Mistakes
Worse Than Others deployment, the people I worked with: acted as though Worse Than Others
my mistakes were worse than others'.
C142001 DRRI1K06 DRRI1-K: Make My Job Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Make My Job
More Difficult deployment, the people I worked with: tried to make my More Difficult
job more difficult to do.
C142002 DRRI1K07 DRRI1-K: Put Me Down Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Put Me Down
deployment, the people I worked with: "put me down" or
treated me in a condescending way.
C142003 DRRI1K08 DRRI1-K: Threatened My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Threatened
Physical Safety deployment, the people I worked with: threatened my My Physical Safety
physical safety.
C142004 DRRI1K09 DRRI1-K: Made Crude Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Made Crude
Sexual Remarks at Me deployment, the people I worked with: made crude and Sexual Remarks at Me
offensive sexual remarks directed at me, either publicly
or privately.
C142005 DRRI1K10 DRRI1-K: Spread Rumors Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Spread
Sexual Activities deployment, the people I worked with: spread negative Rumors Sexual Activities
rumors about my sexual activities.
C142006 DRRI1K11 DRRI1-K: Tried to Talk Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Tried to Talk
into Sexual Acts deployment, the people I worked with: tried to talk me into Sexual Acts
into participating in sexual acts when I didn't want to.
C142007 DRRI1K12 DRRI1-K: Authority Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Authority
Pressure Unwanted Sex deployment, the people I worked with: used a position of Pressure Unwanted Sex
authority to pressure me into unwanted sexual activity.
C142008 DRRI1K13 DRRI1-K: Offered Reward Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Offered
Take Part in Sex deployment, the people I worked with: offered me a Reward Take Part in Sex
specific reward or special treatment to take part in sexual
behavior.
C142009 DRRI1K14 DRRI1-K: Threatened Me Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Threatened
If Not Sex deployment, the people I worked with: threatened me Me If Not Sex
with some sort of retaliation if I was not sexually
cooperative (for example, the threat of negative review or
physical violence).
C142010 DRRI1K15 DRRI1-K: Touched Sexual Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Touched
Way Against Will deployment, the people I worked with: touched me in a Sexual Way Against Will
sexual way against my will.
C142011 DRRI1K16 DRRI1-K: Physically Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Physically
Forced to Have Sex deployment, the people I worked with: physically forced Forced to Have Sex
me to have sex.
C142012 DRRI1L01 DRRI1-L: Effect Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Effect
Deployment Relationship deployment, I was concerned about: the effect of the Deployment Relationship
deployment on my relationship with my spouse or
significant other.
page 381 of 1925

C141673 DRRI1TC
Code Value
C142013 DRRI1L02 DRRI1-L: Missing Out on Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Missing Out
Children Growth deployment, I was concerned about: missing out on my on Children Growth
children's growth and development.
C142014 DRRI1L03 DRRI1-L: Missing Family Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Missing
Events at Home deployment, I was concerned about: missing important Family Events at Home
family events at home such as birthdays, weddings,
funerals, graduations, etc.
C142015 DRRI1L04 DRRI1-L: Safety and Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Safety and
Well-being of Spouse deployment, I was concerned about: the safety and well- Well-being of Spouse
being of my spouse or significant other.
C142016 DRRI1L05 DRRI1-L: Safety and Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Safety and
Well-being of Child deployment, I was concerned about: the safety and well- Well-being of Child
being of my child(ren).
C142017 DRRI1L06 DRRI1-L: Unable to Help Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Unable to
Family If Crisis deployment, I was concerned about: being unable to help Help Family If Crisis
my family if there was some kind of crisis or emergency.
C142018 DRRI1L07 DRRI1-L: Inability Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Inability
Manage Family Affairs deployment, I was concerned about: my inability to Manage Family Affairs
directly manage or control family affairs.
C142019 DRRI1L08 DRRI1-L: Damaging Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Damaging
Career Because Deploy deployment, I was concerned about: damaging my career Career Because Deploy
because of the deployment.
C142020 DRRI1L09 DRRI1-L: Care Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Care
Child/Dependents deployment, I was concerned about: the care that my Child/Dependents
Receiving child(ren) or other dependents were receiving. Receiving
C142021 DRRI1L10 DRRI1-L: Being Cheated Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Being
on by My Spouse deployment, I was concerned about: being cheated on by Cheated on by My Spouse
my spouse or significant other.
C142022 DRRI1L11 DRRI1-L: Family Ability Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Family Ability
Cope With Stress deployment, I was concerned about: my family's ability to Cope With Stress
cope with the stress of the deployment.
C142023 DRRI1L12 DRRI1-L: Spouse Ability Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Spouse
Manage Household deployment, I was concerned about: my spouse or Ability Manage Household
significant other's ability to manage the household (for
example, chores, bills, home repairs, etc.).
C142024 DRRI1L13 DRRI1-L: Losing My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Losing My
Civilian Job deployment, I was concerned about: losing my civilian Civilian Job
job because of the deployment.
C142025 DRRI1L14 DRRI1-L: Effect Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Effect
Relationship My Children deployment, I was concerned about: the effect of the Relationship My Children
deployment on my relationship with my child(ren).
C142026 DRRI1L15 DRRI1-L: My Family Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: My Family
Financial Situation deployment, I was concerned about: my family's financial Financial Situation
situation.
C142027 DRRI1M01 DRRI1-M: Problems Get Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Problems
in Touch Family deployment: I had problems getting in touch with a Get in Touch Family
family member or other loved one.
C142028 DRRI1M02 DRRI1-M: Someone Close Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Someone
Serious Illness deployment: someone close to me experienced a serious Close Serious Illness
C142029 DRRI1M03 DRRI1-M: Family Member Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Family
Passed Away deployment: a family member or other loved one passed Member Passed Away
away.
C142030 DRRI1M04 DRRI1-M: My Family Had Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: My Family
Money Problems deployment: my family had money problems. Had Money Problems
C142031 DRRI1M05 DRRI1-M: Spouse Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Spouse
Cheated on Me deployment: a spouse or significant other cheated on me. Cheated on Me
C142032 DRRI1M06 DRRI1-M: Spouse Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Spouse
Suspected I Cheated deployment: a spouse or significant other suspected that Suspected I Cheated
I had cheated on him/her.
C142033 DRRI1M07 DRRI1-M: Relationship Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Relationship
With Spouse Ended deployment: my relationship with a spouse or significant With Spouse Ended
other ended.
page 382 of 1925

C141673 DRRI1TC
Code Value
C142034 DRRI1M08 DRRI1-M: Had Major Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Had Major
Conflict With Family deployment: I had a major conflict with a family member Conflict With Family
or other loved one.
C142035 DRRI1M09 DRRI1-M: Family Had Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Family Had
Difficulty Adjusting deployment: a family member or other loved one had Difficulty Adjusting
serious difficulty adjusting to my absence.
C142036 DRRI1M10 DRRI1-M: My Home Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: My Home
Robbed deployment: my home was robbed and/or my belongings Was Robbed
were stolen.
C142037 DRRI1M11 DRRI1-M: Family Member Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Family
Wasted Money deployment: a family member or other person I trusted Member Wasted Money
wasted or mismanaged my money.
C142038 DRRI1M12 DRRI1-M: Loved One Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Loved One
Things I Disapproved deployment: I learned that a loved one was doing things Things I Disapproved
I disapproved of.
C142039 DRRI1M13 DRRI1-M: Fam Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Fam
Dangerous Military Duties deployment: a family member or other loved one Dangerous Military Duties
participated in dangerous military duties.
C142040 DRRI1M14 DRRI1-M: Family Got Into Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Family Got
Trouble deployment: a family member got into trouble at home, Into Trouble
at school, or in the community.
C142041 DRRI1N01 DRRI1-N: Robbed/Had Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Robbed/Had
My Home Broken Into returning: I was robbed or had my home broken into. My Home Broken Into
C142042 DRRI1N02 DRRI1-N: Unwanted Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Unwanted
Sexual Activity returning: I experienced unwanted sexual activity as a Sexual Activity
result of force, threat or harm, or manipulation.
C142043 DRRI1N03 DRRI1-N: Went Through Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Went
Divorce/Was Left returning: I went through a divorce or have been left by a Through Divorce/Was Left
partner or significant other.
C142044 DRRI1N04 DRRI1-N: Problems Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Problems
Getting Healthcare returning: I had problems getting access to adequate Getting Healthcare
healthcare.
C142045 DRRI1N05 DRRI1-N: Experienced Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Experienced
Natural Disaster returning: I experienced a natural disaster (for example, Natural Disaster
a hurricane), a fire, or an accident in which I or someone
close to me was hurt or had serious property damage.
C142046 DRRI1N06 DRRI1-N: Someone Close Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Someone
Serious Illness returning: someone close to me has experienced a Close Serious Illness
serious illness, injury, or mental health problem (for
example, cancer, alcohol/drug problem).
C142047 DRRI1N07 DRRI1-N: Witnessed Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Witnessed
Someone Assaulted returning: I have witnessed someone being seriously Someone Assaulted
C142048 DRRI1N08 DRRI1-N: Lost My Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Lost My
Job/Trouble Finding Job returning: I lost my job or had serious trouble finding a Job/Trouble Finding Job
job.
C142049 DRRI1N09 DRRI1-N: Emotionally Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Emotionally
Mistreated returning: I have been emotionally mistreated (for Mistreated
example, ignored or repeatedly told I was no good).
C142050 DRRI1N10 DRRI1-N: Serious Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Serious
Financial Problems returning: I have experienced serious financial problems. Financial Problems
C142051 DRRI1N11 DRRI1-N: Serious Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Serious
Physical Health Problem returning: I have experienced serious physical or mental Physical Health Problem
health problems.
C142052 DRRI1N12 DRRI1-N: Stressful Legal Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Stressful
Problems returning: I have experienced stressful legal problems Legal Problems
(for example, being sued, suing someone else, or being in
a custody battle).
C142053 DRRI1N13 DRRI1-N: Injured by Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Injured by
Another Person returning: I have been seriously physically injured by Another Person
another person (for example, hit or beaten up).
C142054 DRRI1N14 DRRI1-N: Someone Close Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Someone
to Me Has Died returning: someone close to me has died. Close to Me Has Died
page 383 of 1925

C141673 DRRI1TC
Code Value
C142055 DRRI1O01 DRRI1-O: People Made Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: People Made
Me Feel at Home returning: the American people made me feel at home. Me Feel at Home
C142056 DRRI1O02 DRRI1-O: People Made Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: People Made
Me Feel Proud returning: people made me feel proud to have served my Me Feel Proud
country in the Armed Forces.
C142057 DRRI1O03 DRRI1-O: Family Make Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Family Make
Me Better When Down returning: my family members and/or friends make me Me Better When Down
feel better when I am down.
C142058 DRRI1O04 DRRI1-O: Go to Family Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Go to Family
When Need Advice returning: I can go to family members or friends when I When Need Advice
need good advice.
C142059 DRRI1O05 DRRI1-O: Family/Friends Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O:
Understand returning: my family and friends understand what I have Family/Friends
been through in the Armed Forces. Understand
C142060 DRRI1O06 DRRI1-O: I Can Talk Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: I Can Talk
About My Deployment returning: there are family and/or friends with whom I About My Deployment
can talk about my deployment experiences.
C142061 DRRI1O07 DRRI1-O: Family Would Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Family Would
Lend Money returning: my family members or friends would lend me Lend Money
money if I needed it.
C142062 DRRI1O08 DRRI1-O: Family Would Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Family Would
Help Move returning: my family members or friends would help me Help Move
move my belongings if I needed help.
C142063 DRRI1O09 DRRI1-O: Someone Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Someone
Would Help With Tasks returning: if I were unable to attend to daily chores, there Would Help With Tasks
is someone who would help me with these tasks.
C142064 DRRI1O10 DRRI1-O: When Ill Family Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: When Ill
Will Help Out returning: when I am ill, family members or friends will Family Will Help Out
help out until I am well.
C142065 DRRI1P01 DRRI1-P: Input Sought Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Input Sought
Family Decisions returning: my input is sought on important family Family Decisions
decisions.
C142066 DRRI1P02 DRRI1-P: Feel Like I Fit in Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Feel Like I Fit
With Family returning: I feel like I fit in with my family. in With Family
C142067 DRRI1P03 DRRI1-P: Family Know Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Family Know
What I Think/Feel returning: family members know what I think and how I What I Think/Feel
feel about things.
C142068 DRRI1P04 DRRI1-P: Contribution Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Contribution
Family Appreciated returning: I feel like my contributions to my family are Family Appreciated
appreciated.
C142069 DRRI1P05 DRRI1-P: Share Interests Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Share
With Family returning: I share many common interests and activities Interests With Family
C142070 DRRI1P06 DRRI1-P: Opinions Valued Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Opinions
by Family returning: my opinions are valued by other family Valued by Family
members.
C142071 DRRI1P07 DRRI1-P: I am Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: I am
Affectionate With Family returning: I am affectionate with family members. Affectionate With Family
C142072 DRRI1P08 DRRI1-P: Play Important Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Play
Role in Family returning: I play an important role in my family. Important Role in Family
C142073 DRRI1P09 DRRI1-P: Spend My Free Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Spend My
Time With Family returning: I spend as much of my free time with family Free Time With Family
C142074 DRRI1P10 DRRI1-P: Family Tell Me Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Family Tell
When Problem returning: family members tell me when they are having Me When Problem
a problem.
C142075 DRRI1P11 DRRI1-P: Can Be Myself Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Can Be
Around Family returning: I can be myself around family members. Myself Around Family
C142076 DRRI1P12 DRRI1-P: I Get Along Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: I Get Along
Well With My Family returning: I get along well with my family members. Well With My Family
page 384 of 1925

DRRI1TN (Deployment Risk and Resilience Inventory-2 Questionnaire Test Name)
C141672 DRRI1TN
Code Value
C141881 DRRI1-A: Dangerous DRRI1-A: Dangerous Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Dangerous
Military Duties Military Duties deployment: I participated in dangerous military duties. Military Duties
C141878 DRRI1-A: Emotionally DRRI1-A: Emotionally Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Emotionally
Mistreated Mistreated deployment: I was emotionally mistreated (for example, Mistreated
ignored or repeatedly told I was no good).
C141874 DRRI1-A: Experienced DRRI1-A: Experienced Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Experienced
Natural Disaster Natural Disaster deployment: I experienced a natural disaster (for Natural Disaster
example, a hurricane), a fire, or an accident in which I or
someone close to me was hurt or had serious property
damage.
C141883 DRRI1-A: Injured by DRRI1-A: Injured by Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Injured by
Person - Adulthood Person - Adulthood deployment: I was seriously physically injured by another Person - Adulthood
person (for example, hit or beaten up) during adulthood
(age 18 or later).
C141882 DRRI1-A: Injured by DRRI1-A: Injured by Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Injured by
Person - Childhood Person - Childhood deployment: I was seriously physically injured by another Person - Childhood
person (for example, hit or beaten up) during childhood
(before age 18).
C141877 DRRI1-A: Lost My DRRI1-A: Lost My Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Lost My
Job/Trouble Finding Job Job/Trouble Finding Job deployment: I lost my job or had serious trouble finding a Job/Trouble Finding Job
job.
C141871 DRRI1-A: Physically DRRI1-A: Physically Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Physically
Punished by Parent Punished by Parent deployment: I was physically punished by a parent or Punished by Parent
primary caregiver.
C141869 DRRI1-A: Robbed/Had My DRRI1-A: Robbed/Had My Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Robbed/Had
Home Broken Into Home Broken Into deployment: I was robbed or had my home broken into. My Home Broken Into
C141870 DRRI1-A: Saw/Heard DRRI1-A: Saw/Heard Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Saw/Heard
Physical Fight Parent Physical Fight Parent deployment: I saw or heard physical fighting between my Physical Fight Parent
parents or caregivers.
C141879 DRRI1-A: Serious DRRI1-A: Serious Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Serious
Financial Problems Financial Problems deployment: I experienced serious financial problems. Financial Problems
C141880 DRRI1-A: Serious DRRI1-A: Serious Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Serious
Physical Health Problem Physical Health Problem deployment: I experienced serious physical or mental Physical Health Problem
health problems.
C141875 DRRI1-A: Someone Close DRRI1-A: Someone Close Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Someone
Serious Illness Serious Illness deployment: someone close to me experienced a serious Close Serious Illness
C141867 DRRI1-A: Someone Close DRRI1-A: Someone Close Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Someone
to Me Died to Me Died deployment: someone close to me died. Close to Me Died
C141884 DRRI1-A: Stressful Legal DRRI1-A: Stressful Legal Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Stressful
Problems Problems deployment: I experienced stressful legal problems (for Legal Problems
example, being sued, suing someone else, or being in a
custody battle).
C141873 DRRI1-A: Unwanted Sex DRRI1-A: Unwanted Sex Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Unwanted
Activity Adulthood Activity Adulthood deployment: I experienced unwanted sexual activity as a Sex Activity Adulthood
adulthood (age 18 or later).
C141872 DRRI1-A: Unwanted Sex DRRI1-A: Unwanted Sex Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Unwanted
Activity Childhood Activity Childhood deployment: I experienced unwanted sexual activity as a Sex Activity Childhood
childhood (before age 18).
C141868 DRRI1-A: Went Through DRRI1-A: Went Through Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Went
Divorce/Was Left Divorce/Was Left deployment: I went through a divorce or was left by a Through Divorce/Was Left
significant other.
C141876 DRRI1-A: Witnessed DRRI1-A: Witnessed Deployment Risk & Resilience Inventory-2 - Before DRRI-2 - A: Witnessed
Someone Assaulted Someone Assaulted deployment: I witnessed someone being seriously Someone Assaulted
C141888 DRRI1-B: Contribution DRRI1-B: Contribution Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Contribution
Family Appreciated Family Appreciated childhood: I felt like my contributions to my family were Family Appreciated
appreciated.
page 385 of 1925

C141672 DRRI1TN
Code Value
C141887 DRRI1-B: Family Knew DRRI1-B: Family Knew Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Family Knew
What I Thought/Felt What I Thought/Felt childhood: family members knew what I thought and how What I Thought/Felt
I felt about things.
C141894 DRRI1-B: Family Told Me DRRI1-B: Family Told Me Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Family Told
When Problem When Problem childhood: family members told me when they were Me When Problem
having a problem.
C141886 DRRI1-B: Felt Like I Fit in DRRI1-B: Felt Like I Fit in Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Felt Like I Fit
With Family With Family childhood: I felt like I fit in with my family. in With Family
C141885 DRRI1-B: Got Along Well DRRI1-B: Got Along Well Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Got Along
With My Family With My Family childhood: I got along well with my family members. Well With My Family
C141895 DRRI1-B: I Could Be DRRI1-B: I Could Be Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: I Could Be
Myself Around Family Myself Around Family childhood: I could be myself around family members. Myself Around Family
C141891 DRRI1-B: I Was DRRI1-B: I Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: I Was
Affectionate With Family Affectionate With Family childhood: I was affectionate with family members. Affectionate With Family
C141896 DRRI1-B: Input Sought DRRI1-B: Input Sought Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Input Sought
Family Decisions Family Decisions childhood: my input was sought on important family Family Decisions
decisions.
C141890 DRRI1-B: Opinions Were DRRI1-B: Opinions Were Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Opinions
Valued by Family Valued by Family childhood: my opinions were valued by other family Were Valued by Family
members.
C141892 DRRI1-B: Played DRRI1-B: Played Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Played
Important Role in Family Important Role in Family childhood: I played an important role in my family. Important Role in Family
C141889 DRRI1-B: Shared DRRI1-B: Shared Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Shared
Interests With Family Interests With Family childhood: I shared many common interests and activities Interests With Family
C141893 DRRI1-B: Spent My Free DRRI1-B: Spent My Free Deployment Risk & Resilience Inventory-2 - During DRRI-2 - B: Spent My
Time With Family Time With Family childhood: I spent as much of my free time with family Free Time With Family
C141897 DRRI1-C: Climate Was DRRI1-C: Climate Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Climate Was
Uncomfortable Uncomfortable deployment: the climate was uncomfortable. Uncomfortable
C141900 DRRI1-C: Conditions DRRI1-C: Conditions Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Conditions
Extremely Unsanitary Extremely Unsanitary deployment: the conditions I lived in were extremely Extremely Unsanitary
unsanitary.
C141898 DRRI1-C: Deal With DRRI1-C: Deal With Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Deal With
Annoying Animals Annoying Animals deployment: I had to deal with annoying animals, insects, Annoying Animals
or plants.
C141901 DRRI1-C: Didn't Have DRRI1-C: Didn't Have Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Didn't Have
Bathrooms Bathrooms deployment: I didn't have access to bathrooms or Bathrooms
showers when I needed them.
C141899 DRRI1-C: Food Was of DRRI1-C: Food Was of Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Food Was of
Very Poor Quality Very Poor Quality deployment: the food I had to eat was of very poor Very Poor Quality
quality (for example, bad or old MREs).
C141908 DRRI1-C: Hassle With DRRI1-C: Hassle With Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Hassle With
Heavy/Annoying Gear Heavy/Annoying Gear deployment: I had to hassle with putting on and taking Heavy/Annoying Gear
off heavy or annoying gear.
C141903 DRRI1-C: I Was Exposed DRRI1-C: I Was Exposed Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: I Was
to Awful Smells to Awful Smells deployment: I was exposed to awful smells. Exposed to Awful Smells
C141904 DRRI1-C: I Was DRRI1-C: I Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: I Was
Subjected to Loud Noises Subjected to Loud Noises deployment: I was subjected to loud noises. Subjected to Loud Noises
C141909 DRRI1-C: Not Allowed to DRRI1-C: Not Allowed to Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Not Allowed
Get Job Done Get Job Done deployment: I was not allowed to do the things I needed to Get Job Done
to do to get my job done.
C141910 DRRI1-C: Not Have DRRI1-C: Not Have Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Not Have
Adequate Shelter Adequate Shelter deployment: I did not have adequate shelter from Adequate Shelter
uncomfortable living conditions (for example, heat, cold,
wet, etc.).
C141905 DRRI1-C: Restricted DRRI1-C: Restricted Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Restricted
Because Local Custom Because Local Custom deployment: my daily activities were restricted because Because Local Custom
of local religious or ethnic customs.
page 386 of 1925

C141672 DRRI1TN
Code Value
C141907 DRRI1-C: Wasn't Able to DRRI1-C: Wasn't Able to Deployment Risk & Resilience Inventory-2 - During DRRI-2 - C: Wasn't Able
Contact Home Contact Home deployment: I wasn't able to contact home when I to Contact Home
needed to.
Get Privacy Get Privacy deployment: I wasn't able to get as much privacy as I to Get Privacy
needed.
Rest Rest deployment: I wasn't able to get rest when I needed it. to Rest
C141912 DRRI1-D: Assault on DRRI1-D: Assault on Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Assault on
Entrenched Positions Entrenched Positions deployment: I took part in an assault on entrenched or Entrenched Positions
fortified positions that involved naval and/or land forces.
C141914 DRRI1-D: Encountered DRRI1-D: Encountered Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Encountered
Land Mines Land Mines deployment: I encountered land or water mines, booby Land Mines
traps, or roadside bombs (for example, IEDs).
C141915 DRRI1-D: Exposed DRRI1-D: Exposed Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Exposed
Hostile Incoming Fire Hostile Incoming Fire deployment: I was exposed to hostile incoming fire. Hostile Incoming Fire
C141916 DRRI1-D: Exposed to DRRI1-D: Exposed to Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Exposed to
Friendly Fire Friendly Fire deployment: I was exposed to "friendly" fire. Friendly Fire
C141922 DRRI1-D: Fired My DRRI1-D: Fired My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Fired My
Weapon Enemy Weapon Enemy deployment: I fired my weapon at enemy combatants. Weapon Enemy
Combatant Combatant Combatant
C141921 DRRI1-D: Injured DRRI1-D: Injured Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Injured
Combat-Related Incident Combat-Related Incident deployment: I was injured in a combat-related incident. Combat-Related Incident
C141924 DRRI1-D: Locating DRRI1-D: Locating Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Locating
Explosive Devices Explosive Devices deployment: I was involved in locating or disarming Explosive Devices
explosive devices.
C141918 DRRI1-D: Part of Unit DRRI1-D: Part of Unit Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Part of Unit
Fired on Enemy Fired on Enemy deployment: I was part of a land or naval artillery unit Fired on Enemy
that fired on enemy combatants.
C141926 DRRI1-D: Participate DRRI1-D: Participate Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Participate
Hand-to-hand Combat Hand-to-hand Combat deployment: I participated in hand-to-hand combat. Hand-to-hand Combat
C141927 DRRI1-D: Search/Disarm DRRI1-D: Search/Disarm Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D:
Potential Enemy Potential Enemy deployment: I was involved in searching and/or Search/Disarm Potential
disarming potential enemy combatants. Enemy
C141925 DRRI1-D: Searching DRRI1-D: Searching Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Searching
Homes/Buildings Homes/Buildings deployment: I was involved in searching or clearing Homes/Buildings
homes, buildings, or other locations.
C141923 DRRI1-D: Think I DRRI1-D: Think I Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Think I
Wounded/Killed Someone Wounded/Killed Someone deployment: I think I wounded or killed someone during Wounded/Killed Someone
combat operations.
C141917 DRRI1-D: Vehicle/Part of DRRI1-D: Vehicle/Part of Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Vehicle/Part
Convoy Attacked Convoy Attacked deployment: I was in a vehicle (for example, a "humvee", of Convoy Attacked
helicopter, or boat) or part of a convoy that was attacked.
C141911 DRRI1-D: Went on DRRI1-D: Went on Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Went on
Combat Patrols/Missions Combat Patrols/Missions deployment: I went on combat patrols or missions. Combat Patrols/Missions
C141920 DRRI1-D: Witnessed DRRI1-D: Witnessed Deployment Risk & Resilience Inventory-2 - During DRRI-2 - D: Witnessed
Civilians Wounded Civilians Wounded deployment: I personally witnessed civilians (for Civilians Wounded
example, women and children) being seriously wounded
or killed.
Enemy Wounded/Killed Enemy Wounded/Killed deployment: I personally witnessed enemy combatants Enemy Wounded/Killed
being seriously wounded or killed.
Someone Unit Wounded Someone Unit Wounded deployment: I personally witnessed someone from my Someone Unit Wounded
unit or an ally unit being seriously wounded or killed.
C141938 DRRI1-E: Interacted With DRRI1-E: Interacted With Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Interacted
Detainees Detainees deployment: I interacted with detainees or prisoners of With Detainees
war.
C141940 DRRI1-E: Involved DRRI1-E: Involved Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Involved
Handling Human Remains Handling Human Remains deployment: I was involved in handling human remains. Handling Human Remains
page 387 of 1925

C141672 DRRI1TN
Code Value
C141930 DRRI1-E: Observed DRRI1-E: Observed Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Observed
Homes Been Destroyed Homes Been Destroyed deployment: I observed homes or communities that had Homes Been Destroyed
been destroyed.
C141934 DRRI1-E: Saw Americans DRRI1-E: Saw Americans Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw
Had Been Wounded Had Been Wounded deployment: I saw Americans or allies after they had Americans Had Been
been severely wounded or disfigured. Wounded
C141936 DRRI1-E: Saw Bodies of DRRI1-E: Saw Bodies of Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw Bodies
Dead Americans Dead Americans deployment: I saw the bodies of dead Americans or allies. of Dead Americans
Dead Civilians Dead Civilians deployment: I saw the bodies of dead civilians. of Dead Civilians
Dead Enemy Dead Enemy deployment: I saw the bodies of dead enemy of Dead Enemy
combatants.
C141932 DRRI1-E: Saw Civilians DRRI1-E: Saw Civilians Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw Civilians
After Wounded After Wounded deployment: I saw civilians after they had been severely After Wounded
wounded or disfigured.
C141933 DRRI1-E: Saw DRRI1-E: Saw Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw
Combatants Had Been Combatants Had Been deployment: I saw enemy combatants after they had Combatants Had Been
Wounded Wounded been severely wounded or disfigured. Wounded
C141928 DRRI1-E: Saw People DRRI1-E: Saw People Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw People
Begging for Food Begging for Food deployment: I saw people begging for food. Begging for Food
C141929 DRRI1-E: Saw Refugees DRRI1-E: Saw Refugees Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Saw
Who Had Lost Homes Who Had Lost Homes deployment: I saw refugees who had lost their homes or Refugees Who Had Lost
belongings. Homes
C141939 DRRI1-E: DRRI1-E: Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E:
Sight/Sound/Smell Dead Sight/Sound/Smell Dead deployment: I was exposed to the sight, sound, or smell Sight/Sound/Smell Dead
Animals Animals of dead or dying animals. Animals
C141931 DRRI1-E: Took Care DRRI1-E: Took Care Deployment Risk & Resilience Inventory-2 - During DRRI-2 - E: Took Care
Injured/Dying People Injured/Dying People deployment: I took care of injured or dying people. Injured/Dying People
C141945 DRRI1-F: Exposed DRRI1-F: Exposed Deployment Risk & Resilience Inventory-2 - Either in DRRI-2 - F: Exposed
Government-issued DEET Government-issued DEET preparation for or during my deployment: I was exposed Government-issued DEET
to government-issued DEET-containing insect repellents.
C141951 DRRI1-F: Exposed to DRRI1-F: Exposed to Deployment Risk & Resilience Inventory-2 - Either in DRRI-2 - F: Exposed to
Burning Trash/Feces Burning Trash/Feces preparation for or during my deployment: I was exposed Burning Trash/Feces
to burning trash or burning feces.
Chlorine Gas Chlorine Gas preparation for or during my deployment: I was exposed Chlorine Gas
to chlorine gas.
Depleted Uranium Depleted Uranium preparation for or during my deployment: I was exposed Depleted Uranium
to depleted uranium in munitions.
Diesel/Fuel on Skin Diesel/Fuel on Skin preparation for or during my deployment: I was exposed Diesel/Fuel on Skin
to diesel or other petrochemical fuel on my skin.
Fumes From Heaters Fumes From Heaters preparation for or during my deployment: I was exposed Fumes From Heaters
to fumes or exhaust from heaters or generators, including
heaters in tents.
Mustard Gas Mustard Gas preparation for or during my deployment: I was exposed Mustard Gas
to mustard gas or other blistering agents.
Nerve Gas Agents Nerve Gas Agents preparation for or during my deployment: I was exposed Nerve Gas Agents
to nerve gas agents (for example, sarin).
Nuclear Weapons Nuclear Weapons preparation for or during my deployment: I was exposed Nuclear Weapons
to nuclear, biological, or chemical weapons.
Other Pesticides Other Pesticides preparation for or during my deployment: I was exposed Other Pesticides
to other pesticides (for example, in flea collars, uniforms,
or the environment).
page 388 of 1925

C141672 DRRI1TN
Code Value
Smoke/Air Pollution Smoke/Air Pollution preparation for or during my deployment: I was exposed Smoke/Air Pollution
to smoke or other air pollution.
C141942 DRRI1-F: Received DRRI1-F: Received Deployment Risk & Resilience Inventory-2 - Either in DRRI-2 - F: Received
Vaccinations Vaccinations preparation for or during my deployment: I received Vaccinations
preventative vaccinations by injection (for example, to
prevent anthrax or botulism).
C141941 DRRI1-F: Took DRRI1-F: Took Deployment Risk & Resilience Inventory-2 - Either in DRRI-2 - F: Took
Preventative Pills Preventative Pills preparation for or during my deployment: I took Preventative Pills
preventative pills (for example, to protect against nerve
gas).
C141960 DRRI1-G: Concern DRRI1-G: Concern Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Concern
Rocket/Mortar Would Hit Rocket/Mortar Would Hit deployment: I was concerned that a rocket or mortar Rocket/Mortar Would Hit
would hit our living quarters.
C141961 DRRI1-G: Concerned DRRI1-G: Concerned Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Concerned
Depleted Uranium Depleted Uranium deployment: I was concerned that I might be exposed to Depleted Uranium
depleted uranium in munitions.
Encounter Explosive Encounter Explosive deployment: I was concerned that I would encounter an Encounter Explosive
explosive device (for example, a roadside bomb, mine, or
booby trap).
Infectious Disease Infectious Disease deployment: I was concerned about getting an infectious Infectious Disease
disease.
Locals Against Us Locals Against Us deployment: I was concerned that the locals who were Locals Against Us
supposed to be helping us were actually working against
us.
Medicine Make Me Sick Medicine Make Me Sick deployment: I was concerned that the medicine I was Medicine Make Me Sick
given to protect me from illness would make me sick.
Taken Hostage Taken Hostage deployment: I was concerned that I might be taken Taken Hostage
hostage.
Trapped in Crossfire Trapped in Crossfire deployment: I was concerned about being trapped in the Trapped in Crossfire
crossfire of rival factions.
C141959 DRRI1-G: Feared Sick DRRI1-G: Feared Sick Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Feared Sick
From Pesticides From Pesticides deployment: I feared that I would become sick from From Pesticides
pesticides (for example, bug spray) or other routinely
used chemicals.
C141956 DRRI1-G: Felt in Danger DRRI1-G: Felt in Danger Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Felt in
of Being Wounded of Being Wounded deployment: I felt I was in great danger of being Danger of Being Wounded
wounded (for example, losing a limb).
C141955 DRRI1-G: Health Might DRRI1-G: Health Might Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Health Might
Suffer NBC Agents Suffer NBC Agents deployment: I was concerned that my health might suffer Suffer NBC Agents
due to exposure to nuclear, biological, or chemical (NBC)
agents.
C141962 DRRI1-G: Thought I DRRI1-G: Thought I Deployment Risk & Resilience Inventory-2 - During DRRI-2 - G: Thought I
Would Never Survive Would Never Survive deployment: I thought I would never survive. Would Never Survive
C141969 DRRI1-H: Accurately DRRI1-H: Accurately Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Accurately
Informed About Role Informed About Role preparation for deployment: I was accurately informed Informed About Role
about the role my unit was expected to play in the
deployment.
C141967 DRRI1-H: Confident DRRI1-H: Confident Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Confident
Ability Use Equipment Ability Use Equipment preparation for deployment: the training I received made Ability Use Equipment
me feel confident in my ability to use my equipment.
C141974 DRRI1-H: Confident to DRRI1-H: Confident to Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Confident to
Perform Tasks Perform Tasks preparation for deployment: the training I received made Perform Tasks
me feel confident in my ability to perform tasks assigned
to me during deployment.
C141966 DRRI1-H: Had All DRRI1-H: Had All Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Had All
Supplies Needed Supplies Needed preparation for deployment: I had all the supplies and Supplies Needed
equipment needed to get my job done.
page 389 of 1925

C141672 DRRI1TN
Code Value
C141970 DRRI1-H: Had Enough DRRI1-H: Had Enough Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Had Enough
Gear in Case Attack Gear in Case Attack preparation for deployment: I had enough gear to protect Gear in Case Attack
myself in case of an attack.
C141972 DRRI1-H: Military Duties DRRI1-H: Military Duties Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Military
What I Expected What I Expected preparation for deployment: my military duties and Duties What I Expected
assignments were what I expected.
C141968 DRRI1-H: Prepared to DRRI1-H: Prepared to Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Prepared to
Deal With Climate Deal With Climate preparation for deployment: the training I received Deal With Climate
prepared me to deal with the region's climate.
C141973 DRRI1-H: Prepared to DRRI1-H: Prepared to Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Prepared to
Operate as Team Operate as Team preparation for deployment: my unit was well-prepared Operate as Team
to operate as a team during deployment.
C141975 DRRI1-H: Taught Me DRRI1-H: Taught Me Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Taught Me
Everything I Needed Everything I Needed preparation for deployment: the training I received Everything I Needed
taught me everything I needed to know for deployment.
C141971 DRRI1-H: Training for DRRI1-H: Training for Deployment Risk & Resilience Inventory-2 - In DRRI-2 - H: Training for
Deployment Deployment preparation for deployment: I received appropriate Deployment
training for the nature of the deployment I experienced.
C141978 DRRI1-I: Could Count on DRRI1-I: Could Count on Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Could Count
Family Advice Family Advice deployment: I could count on my family members or on Family Advice
friends at home for good advice.
C141976 DRRI1-I: Family Sincerely DRRI1-I: Family Sincerely Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Family
Interested Interested deployment: family members and/or friends at home Sincerely Interested
were sincerely interested in hearing what was going on
with me.
C141977 DRRI1-I: Had Family I DRRI1-I: Had Family I Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Had Family I
Could Talk To Could Talk To deployment: I had family members or friends at home I Could Talk To
could talk to when I had a problem.
C141981 DRRI1-I: Happy DRRI1-I: Happy Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Happy
Communication From Communication From deployment: I was happy with the amount of Communication From
Home Home communication I received from people at home. Home
C141982 DRRI1-I: Happy With DRRI1-I: Happy With Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Happy With
Support From Home Support From Home deployment: I was happy with the amount of support I Support From Home
received from people at home.
C141983 DRRI1-I: People at Home DRRI1-I: People at Home Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: People at
Show They Cared Show They Cared deployment: people at home did things to show they Home Show They Cared
cared about me.
C141979 DRRI1-I: Relatives Look DRRI1-I: Relatives Look Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Relatives
Out for Family Out for Family deployment: relatives or friends at home could be Look Out for Family
counted on to look out for the well-being of my family or
other dependents (including pets).
C141980 DRRI1-I: Relatives Take DRRI1-I: Relatives Take Deployment Risk & Resilience Inventory-2 - During DRRI-2 - I: Relatives
Care of Finances Care of Finances deployment: relatives or friends at home could be Take Care of Finances
counted on to take care of my finances, property, or
belongings if needed.
C141993 DRRI1-J: Could Go to DRRI1-J: Could Go to Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Could Go to
Leaders If Problem Leaders If Problem deployment: I could go to unit leaders for help if I had a Leaders If Problem
problem or concern.
C141986 DRRI1-J: Fellow Unit DRRI1-J: Fellow Unit Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Fellow Unit
Appreciated Efforts Appreciated Efforts deployment: my fellow unit members appreciated my Appreciated Efforts
efforts.
C141991 DRRI1-J: Felt Like My DRRI1-J: Felt Like My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Felt Like My
Efforts Counted Efforts Counted deployment: I felt like my efforts really counted to the Efforts Counted
leaders in my unit.
C141995 DRRI1-J: Felt Valued by DRRI1-J: Felt Valued by Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Felt Valued
Leaders of Unit Leaders of Unit deployment: I felt valued by the leaders of my unit. by Leaders of Unit
C141987 DRRI1-J: Felt Valued DRRI1-J: Felt Valued Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Felt Valued
Fellow Unit Members Fellow Unit Members deployment: I felt valued by my fellow unit members. Fellow Unit Members
C141990 DRRI1-J: Leader DRRI1-J: Leader Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Leader
Interested What Thought Interested What Thought deployment: my unit leader(s) were interested in what I Interested What Thought
thought and how I felt about things.
C141994 DRRI1-J: Leaders DRRI1-J: Leaders Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Leaders
Interested in Welfare Interested in Welfare deployment: the leaders of my unit were interested in my Interested in Welfare
personal welfare.
page 390 of 1925

C141672 DRRI1TN
Code Value
C141984 DRRI1-J: My Unit Was DRRI1-J: My Unit Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: My Unit Was
Like Family to Me Like Family to Me deployment: my unit was like family to me. Like Family to Me
C141985 DRRI1-J: People in Unit DRRI1-J: People in Unit Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: People in Unit
Were Trustworthy Were Trustworthy deployment: people in my unit were trustworthy. Were Trustworthy
C141992 DRRI1-J: Service DRRI1-J: Service Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Service
Appreciated by Leaders Appreciated by Leaders deployment: my service was appreciated by the leaders Appreciated by Leaders
in my unit.
C141988 DRRI1-J: Unit Interested DRRI1-J: Unit Interested Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Unit
My Well-being My Well-being deployment: members of my unit were interested in my Interested My Well-being
well-being.
C141989 DRRI1-J: Unit Interested DRRI1-J: Unit Interested Deployment Risk & Resilience Inventory-2 - During DRRI-2 - J: Unit
What I Thought What I Thought deployment: my fellow unit members were interested in Interested What I
what I thought and how I felt about things. Thought
C142007 DRRI1-K: Authority DRRI1-K: Authority Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Authority
Pressure Unwanted Sex Pressure Unwanted Sex deployment, the people I worked with: used a position of Pressure Unwanted Sex
authority to pressure me into unwanted sexual activity.
C141998 DRRI1-K: Had to Work DRRI1-K: Had to Work Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Had to Work
Harder Prove Myself Harder Prove Myself deployment, the people I worked with: treated me as if I Harder Prove Myself
had to work harder than others to prove myself.
C142004 DRRI1-K: Made Crude DRRI1-K: Made Crude Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Made Crude
Sexual Remarks at Me Sexual Remarks at Me deployment, the people I worked with: made crude and Sexual Remarks at Me
offensive sexual remarks directed at me, either publicly
or privately.
C142001 DRRI1-K: Make My Job DRRI1-K: Make My Job Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Make My Job
More Difficult More Difficult deployment, the people I worked with: tried to make my More Difficult
job more difficult to do.
C142000 DRRI1-K: My Mistakes DRRI1-K: My Mistakes Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: My Mistakes
Worse Than Others Worse Than Others deployment, the people I worked with: acted as though Worse Than Others
my mistakes were worse than others'.
C142008 DRRI1-K: Offered Reward DRRI1-K: Offered Reward Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Offered
Take Part in Sex Take Part in Sex deployment, the people I worked with: offered me a Reward Take Part in Sex
specific reward or special treatment to take part in sexual
behavior.
C142011 DRRI1-K: Physically DRRI1-K: Physically Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Physically
Forced to Have Sex Forced to Have Sex deployment, the people I worked with: physically forced Forced to Have Sex
me to have sex.
C142002 DRRI1-K: Put Me Down DRRI1-K: Put Me Down Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Put Me Down
deployment, the people I worked with: "put me down" or
treated me in a condescending way.
C141999 DRRI1-K: Questioned My DRRI1-K: Questioned My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Questioned
Abilities Perform Abilities Perform deployment, the people I worked with: questioned my My Abilities Perform
abilities or commitment to perform my job effectively.
C142005 DRRI1-K: Spread Rumors DRRI1-K: Spread Rumors Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Spread
Sexual Activities Sexual Activities deployment, the people I worked with: spread negative Rumors Sexual Activities
rumors about my sexual activities.
C142009 DRRI1-K: Threatened Me DRRI1-K: Threatened Me Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Threatened
If Not Sex If Not Sex deployment, the people I worked with: threatened me Me If Not Sex
with some sort of retaliation if I was not sexually
cooperative (for example, the threat of negative review or
physical violence).
C142003 DRRI1-K: Threatened My DRRI1-K: Threatened My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Threatened
Physical Safety Physical Safety deployment, the people I worked with: threatened my My Physical Safety
physical safety.
C142010 DRRI1-K: Touched Sexual DRRI1-K: Touched Sexual Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Touched
Way Against Will Way Against Will deployment, the people I worked with: touched me in a Sexual Way Against Will
sexual way against my will.
C141996 DRRI1-K: Treated in DRRI1-K: Treated in Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Treated in
Overly Critical Way Overly Critical Way deployment, the people I worked with: treated me in an Overly Critical Way
overly critical way.
C142006 DRRI1-K: Tried to Talk DRRI1-K: Tried to Talk Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K: Tried to Talk
into Sexual Acts into Sexual Acts deployment, the people I worked with: tried to talk me into Sexual Acts
into participating in sexual acts when I didn't want to.
page 391 of 1925

C141672 DRRI1TN
Code Value
C141997 DRRI1-K: Uncooperative DRRI1-K: Uncooperative Deployment Risk & Resilience Inventory-2 - During DRRI-2 - K:
Working With Me Working With Me deployment, the people I worked with: behaved in way Uncooperative Working
that was uncooperative when working with me. With Me
C142021 DRRI1-L: Being Cheated DRRI1-L: Being Cheated Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Being
on by My Spouse on by My Spouse deployment, I was concerned about: being cheated on by Cheated on by My Spouse
my spouse or significant other.
C142020 DRRI1-L: Care DRRI1-L: Care Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Care
Child/Dependents Child/Dependents deployment, I was concerned about: the care that my Child/Dependents
Receiving Receiving child(ren) or other dependents were receiving. Receiving
C142019 DRRI1-L: Damaging DRRI1-L: Damaging Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Damaging
Career Because Deploy Career Because Deploy deployment, I was concerned about: damaging my career Career Because Deploy
because of the deployment.
C142012 DRRI1-L: Effect DRRI1-L: Effect Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Effect
Deployment Relationship Deployment Relationship deployment, I was concerned about: the effect of the Deployment Relationship
deployment on my relationship with my spouse or
significant other.
C142025 DRRI1-L: Effect DRRI1-L: Effect Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Effect
Relationship My Children Relationship My Children deployment, I was concerned about: the effect of the Relationship My Children
deployment on my relationship with my child(ren).
C142022 DRRI1-L: Family Ability DRRI1-L: Family Ability Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Family Ability
Cope With Stress Cope With Stress deployment, I was concerned about: my family's ability to Cope With Stress
cope with the stress of the deployment.
C142018 DRRI1-L: Inability DRRI1-L: Inability Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Inability
Manage Family Affairs Manage Family Affairs deployment, I was concerned about: my inability to Manage Family Affairs
directly manage or control family affairs.
C142024 DRRI1-L: Losing My DRRI1-L: Losing My Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Losing My
Civilian Job Civilian Job deployment, I was concerned about: losing my civilian Civilian Job
job because of the deployment.
C142014 DRRI1-L: Missing Family DRRI1-L: Missing Family Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Missing
Events at Home Events at Home deployment, I was concerned about: missing important Family Events at Home
family events at home such as birthdays, weddings,
funerals, graduations, etc.
C142013 DRRI1-L: Missing Out on DRRI1-L: Missing Out on Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Missing Out
Children Growth Children Growth deployment, I was concerned about: missing out on my on Children Growth
children's growth and development.
C142026 DRRI1-L: My Family DRRI1-L: My Family Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: My Family
Financial Situation Financial Situation deployment, I was concerned about: my family's financial Financial Situation
situation.
C142016 DRRI1-L: Safety and DRRI1-L: Safety and Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Safety and
Well-being of Child Well-being of Child deployment, I was concerned about: the safety and well- Well-being of Child
being of my child(ren).
C142015 DRRI1-L: Safety and DRRI1-L: Safety and Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Safety and
Well-being of Spouse Well-being of Spouse deployment, I was concerned about: the safety and well- Well-being of Spouse
being of my spouse or significant other.
C142023 DRRI1-L: Spouse Ability DRRI1-L: Spouse Ability Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Spouse
Manage Household Manage Household deployment, I was concerned about: my spouse or Ability Manage Household
significant other's ability to manage the household (for
example, chores, bills, home repairs, etc.).
C142017 DRRI1-L: Unable to Help DRRI1-L: Unable to Help Deployment Risk & Resilience Inventory-2 - During DRRI-2 - L: Unable to
Family If Crisis Family If Crisis deployment, I was concerned about: being unable to help Help Family If Crisis
my family if there was some kind of crisis or emergency.
C142039 DRRI1-M: Fam DRRI1-M: Fam Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Fam
Dangerous Military Duties Dangerous Military Duties deployment: a family member or other loved one Dangerous Military Duties
participated in dangerous military duties.
C142040 DRRI1-M: Family Got Into DRRI1-M: Family Got Into Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Family Got
Trouble Trouble deployment: a family member got into trouble at home, Into Trouble
at school, or in the community.
C142035 DRRI1-M: Family Had DRRI1-M: Family Had Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Family Had
Difficulty Adjusting Difficulty Adjusting deployment: a family member or other loved one had Difficulty Adjusting
serious difficulty adjusting to my absence.
C142029 DRRI1-M: Family Member DRRI1-M: Family Member Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Family
Passed Away Passed Away deployment: a family member or other loved one passed Member Passed Away
away.
page 392 of 1925

C141672 DRRI1TN
Code Value
C142037 DRRI1-M: Family Member DRRI1-M: Family Member Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Family
Wasted Money Wasted Money deployment: a family member or other person I trusted Member Wasted Money
wasted or mismanaged my money.
C142034 DRRI1-M: Had Major DRRI1-M: Had Major Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Had Major
Conflict With Family Conflict With Family deployment: I had a major conflict with a family member Conflict With Family
or other loved one.
C142038 DRRI1-M: Loved One DRRI1-M: Loved One Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Loved One
Things I Disapproved Things I Disapproved deployment: I learned that a loved one was doing things Things I Disapproved
I disapproved of.
C142030 DRRI1-M: My Family Had DRRI1-M: My Family Had Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: My Family
Money Problems Money Problems deployment: my family had money problems. Had Money Problems
C142036 DRRI1-M: My Home Was DRRI1-M: My Home Was Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: My Home
Robbed Robbed deployment: my home was robbed and/or my belongings Was Robbed
were stolen.
C142027 DRRI1-M: Problems Get DRRI1-M: Problems Get Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Problems
in Touch Family in Touch Family deployment: I had problems getting in touch with a Get in Touch Family
family member or other loved one.
C142033 DRRI1-M: Relationship DRRI1-M: Relationship Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Relationship
With Spouse Ended With Spouse Ended deployment: my relationship with a spouse or significant With Spouse Ended
other ended.
C142028 DRRI1-M: Someone Close DRRI1-M: Someone Close Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Someone
Serious Illness Serious Illness deployment: someone close to me experienced a serious Close Serious Illness
C142031 DRRI1-M: Spouse DRRI1-M: Spouse Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Spouse
Cheated on Me Cheated on Me deployment: a spouse or significant other cheated on me. Cheated on Me
C142032 DRRI1-M: Spouse DRRI1-M: Spouse Deployment Risk & Resilience Inventory-2 - During DRRI-2 - M: Spouse
Suspected I Cheated Suspected I Cheated deployment: a spouse or significant other suspected that Suspected I Cheated
I had cheated on him/her.
C142049 DRRI1-N: Emotionally DRRI1-N: Emotionally Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Emotionally
Mistreated Mistreated returning: I have been emotionally mistreated (for Mistreated
example, ignored or repeatedly told I was no good).
C142045 DRRI1-N: Experienced DRRI1-N: Experienced Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Experienced
Natural Disaster Natural Disaster returning: I experienced a natural disaster (for example, Natural Disaster
a hurricane), a fire, or an accident in which I or someone
close to me was hurt or had serious property damage.
C142053 DRRI1-N: Injured by DRRI1-N: Injured by Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Injured by
Another Person Another Person returning: I have been seriously physically injured by Another Person
another person (for example, hit or beaten up).
C142048 DRRI1-N: Lost My DRRI1-N: Lost My Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Lost My
Job/Trouble Finding Job Job/Trouble Finding Job returning: I lost my job or had serious trouble finding a Job/Trouble Finding Job
job.
C142044 DRRI1-N: Problems DRRI1-N: Problems Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Problems
Getting Healthcare Getting Healthcare returning: I had problems getting access to adequate Getting Healthcare
healthcare.
C142041 DRRI1-N: Robbed/Had DRRI1-N: Robbed/Had Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Robbed/Had
My Home Broken Into My Home Broken Into returning: I was robbed or had my home broken into. My Home Broken Into
C142050 DRRI1-N: Serious DRRI1-N: Serious Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Serious
Financial Problems Financial Problems returning: I have experienced serious financial problems. Financial Problems
C142051 DRRI1-N: Serious DRRI1-N: Serious Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Serious
Physical Health Problem Physical Health Problem returning: I have experienced serious physical or mental Physical Health Problem
health problems.
C142046 DRRI1-N: Someone Close DRRI1-N: Someone Close Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Someone
Serious Illness Serious Illness returning: someone close to me has experienced a Close Serious Illness
serious illness, injury, or mental health problem (for
example, cancer, alcohol/drug problem).
C142054 DRRI1-N: Someone Close DRRI1-N: Someone Close Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Someone
to Me Has Died to Me Has Died returning: someone close to me has died. Close to Me Has Died
C142052 DRRI1-N: Stressful Legal DRRI1-N: Stressful Legal Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Stressful
Problems Problems returning: I have experienced stressful legal problems Legal Problems
(for example, being sued, suing someone else, or being in
a custody battle).
page 393 of 1925

C141672 DRRI1TN
Code Value
C142042 DRRI1-N: Unwanted DRRI1-N: Unwanted Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Unwanted
Sexual Activity Sexual Activity returning: I experienced unwanted sexual activity as a Sexual Activity
result of force, threat or harm, or manipulation.
C142043 DRRI1-N: Went Through DRRI1-N: Went Through Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Went
Divorce/Was Left Divorce/Was Left returning: I went through a divorce or have been left by a Through Divorce/Was Left
partner or significant other.
C142047 DRRI1-N: Witnessed DRRI1-N: Witnessed Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - N: Witnessed
Someone Assaulted Someone Assaulted returning: I have witnessed someone being seriously Someone Assaulted
C142057 DRRI1-O: Family Make DRRI1-O: Family Make Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Family Make
Me Better When Down Me Better When Down returning: my family members and/or friends make me Me Better When Down
feel better when I am down.
C142062 DRRI1-O: Family Would DRRI1-O: Family Would Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Family Would
Help Move Help Move returning: my family members or friends would help me Help Move
move my belongings if I needed help.
C142061 DRRI1-O: Family Would DRRI1-O: Family Would Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Family Would
Lend Money Lend Money returning: my family members or friends would lend me Lend Money
money if I needed it.
C142059 DRRI1-O: Family/Friends DRRI1-O: Family/Friends Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O:
Understand Understand returning: my family and friends understand what I have Family/Friends
been through in the Armed Forces. Understand
C142058 DRRI1-O: Go to Family DRRI1-O: Go to Family Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Go to Family
When Need Advice When Need Advice returning: I can go to family members or friends when I When Need Advice
need good advice.
C142060 DRRI1-O: I Can Talk DRRI1-O: I Can Talk Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: I Can Talk
About My Deployment About My Deployment returning: there are family and/or friends with whom I About My Deployment
can talk about my deployment experiences.
C142055 DRRI1-O: People Made DRRI1-O: People Made Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: People Made
Me Feel at Home Me Feel at Home returning: the American people made me feel at home. Me Feel at Home
C142056 DRRI1-O: People Made DRRI1-O: People Made Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: People Made
Me Feel Proud Me Feel Proud returning: people made me feel proud to have served my Me Feel Proud
country in the Armed Forces.
C142063 DRRI1-O: Someone DRRI1-O: Someone Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: Someone
Would Help With Tasks Would Help With Tasks returning: if I were unable to attend to daily chores, there Would Help With Tasks
is someone who would help me with these tasks.
C142064 DRRI1-O: When Ill Family DRRI1-O: When Ill Family Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - O: When Ill
Will Help Out Will Help Out returning: when I am ill, family members or friends will Family Will Help Out
help out until I am well.
C142075 DRRI1-P: Can Be Myself DRRI1-P: Can Be Myself Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Can Be
Around Family Around Family returning: I can be myself around family members. Myself Around Family
C142068 DRRI1-P: Contribution DRRI1-P: Contribution Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Contribution
Family Appreciated Family Appreciated returning: I feel like my contributions to my family are Family Appreciated
appreciated.
C142067 DRRI1-P: Family Know DRRI1-P: Family Know Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Family Know
What I Think/Feel What I Think/Feel returning: family members know what I think and how I What I Think/Feel
feel about things.
C142074 DRRI1-P: Family Tell Me DRRI1-P: Family Tell Me Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Family Tell
When Problem When Problem returning: family members tell me when they are having Me When Problem
a problem.
C142066 DRRI1-P: Feel Like I Fit in DRRI1-P: Feel Like I Fit in Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Feel Like I Fit
With Family With Family returning: I feel like I fit in with my family. in With Family
C142071 DRRI1-P: I am DRRI1-P: I am Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: I am
Affectionate With Family Affectionate With Family returning: I am affectionate with family members. Affectionate With Family
C142076 DRRI1-P: I Get Along DRRI1-P: I Get Along Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: I Get Along
Well With My Family Well With My Family returning: I get along well with my family members. Well With My Family
C142065 DRRI1-P: Input Sought DRRI1-P: Input Sought Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Input Sought
Family Decisions Family Decisions returning: my input is sought on important family Family Decisions
decisions.
C142070 DRRI1-P: Opinions Valued DRRI1-P: Opinions Valued Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Opinions
by Family by Family returning: my opinions are valued by other family Valued by Family
members.
page 394 of 1925

C141672 DRRI1TN
Code Value
C142072 DRRI1-P: Play Important DRRI1-P: Play Important Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Play
Role in Family Role in Family returning: I play an important role in my family. Important Role in Family
C142069 DRRI1-P: Share Interests DRRI1-P: Share Interests Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Share
With Family With Family returning: I share many common interests and activities Interests With Family
C142073 DRRI1-P: Spend My Free DRRI1-P: Spend My Free Deployment Risk & Resilience Inventory-2 - Since DRRI-2 - P: Spend My
Time With Family Time With Family returning: I spend as much of my free time with family Free Time With Family
page 395 of 1925

DRS01TC (Disability Rating Scale Questionnaire Test Code)
C115402 DRS01TC
Code Value
C115820 DRS0101 DRS01-Eye Opening Disability Rating Scale - Eye opening. DRS - Eye Opening
C115821 DRS0102 DRS01-Communication Disability Rating Scale - Communication ability. DRS - Communication
Ability Ability
C115822 DRS0103 DRS01-Motor Response Disability Rating Scale - Motor response. DRS - Motor Response
C115823 DRS0104 DRS01-Feeding Disability Rating Scale - Feeding (cognitive ability only). DRS - Feeding
C115824 DRS0105 DRS01-Toileting Disability Rating Scale - Toileting (cognitive ability only). DRS - Toileting
C115825 DRS0106 DRS01-Grooming Disability Rating Scale - Grooming (cognitive ability only). DRS - Grooming
C115826 DRS0107 DRS01-Level of Disability Rating Scale - Level of functioning (physical, DRS - Level of
Functioning mental, emotional or social function). Functioning
C115827 DRS0108 DRS01-Employability Disability Rating Scale - Employability (as a full time DRS - Employability
worker, homemaker, or student).
page 396 of 1925

DRS01TN (Disability Rating Scale Questionnaire Test Name)
C115401 DRS01TN
Code Value
C115821 DRS01-Communication DRS01-Communication Disability Rating Scale - Communication ability. DRS - Communication
Ability Ability Ability
C115827 DRS01-Employability DRS01-Employability Disability Rating Scale - Employability (as a full time DRS - Employability
worker, homemaker, or student).
C115820 DRS01-Eye Opening DRS01-Eye Opening Disability Rating Scale - Eye opening. DRS - Eye Opening
C115823 DRS01-Feeding DRS01-Feeding Disability Rating Scale - Feeding (cognitive ability only). DRS - Feeding
C115825 DRS01-Grooming DRS01-Grooming Disability Rating Scale - Grooming (cognitive ability only). DRS - Grooming
C115826 DRS01-Level of DRS01-Level of Disability Rating Scale - Level of functioning (physical, DRS - Level of
Functioning Functioning mental, emotional or social function). Functioning
C115822 DRS01-Motor Response DRS01-Motor Response Disability Rating Scale - Motor response. DRS - Motor Response
C115824 DRS01-Toileting DRS01-Toileting Disability Rating Scale - Toileting (cognitive ability only). DRS - Toileting
page 397 of 1925

DRSTAT (Drug Resistance Status)
C102577 DRSTAT
Code Value
C102633 EXTENSIVE DRUG XDR Resistance to nearly all known drugs, particularly the Extensively Drug
RESISTANCE most efficacious or non-first line drugs, used in the Resistance Process
treatment of a particular disease.
C17745 MULTIPLE DRUG MDR Simultaneous resistance to a spectrum of unrelated drugs Multidrug Resistance
RESISTANCE following exposure to a single agent. Mechanisms involve Process
expression of multidrug efflux pumps (p-glycoprotein),
altered glutathione metabolism, decreased topoisomerase
II activity, and changes in various cellular proteins.
C85563 SUSCEPTIBLE Susceptible The growth of microorganisms are inhibited by the Antimicrobial
usually achievable concentrations of antimicrobial agent Susceptibility Result
when the recommended dosage is used for the site of
infection.
page 398 of 1925

DS01TC (Disease Steps Questionnaire Test Code)
C112437 DS01TC
Code Value
C112549 DS0101 DS01-Disease Steps Disease Steps - Methods: For Disease Steps, classification DS - Disease Steps
Classification of a patient is determined by history and neurologic Classification
examination as well as course of MS.
page 399 of 1925

DS01TN (Disease Steps Questionnaire Test Name)
C112436 DS01TN
Code Value
C112549 DS01-Disease Steps DS01-Disease Steps Disease Steps - Methods: For Disease Steps, classification DS - Disease Steps
Classification Classification of a patient is determined by history and neurologic Classification
examination as well as course of MS.
page 400 of 1925

DSCAT (Category for Disposition Event)
C74558 DSCAT
Code Value
C74590 DISPOSITION EVENT Disposition Event The group of incidents that occur during a clinical trial Protocol Disposition Event
and describe whether a subject completed the study
epoch or the reason this event did not occur. The
subject's disposition is often described for each phase of
the study.
C150824 OTHER EVENT Other Event Other important events that occur during a trial but are Non-Protocol Disposition
not driven by protocol requirements. Event
C74588 PROTOCOL MILESTONE Protocol Milestone Occurrences within some epochs that are initiated by a Protocol Milestone
protocol-specified event. The most common protocol
milestone is "Informed Consent Obtained" which usually
documents the start of the study.
page 401 of 1925

DSPRTYP (Disease Presentation Type)
C127268 DSPRTYP
Code Value
C127606 COMPLEX CYSTIC LESION A lesion that demonstrates both cystic and solid Complex Cystic Lesion
components; the solid components can range from thin
walls (septae) to a solid tissue mass.
C3003 EFFUSION Abnormal collection of fluid in a body cavity. Effusion
C2885 INCREASING ABDOMINAL Ascites Abnormal collection of fluid in the peritoneal cavity. Ascites
DISTENTION OR ASCITES
C4958 LEPTOMENINGEAL A malignant neoplasm that has spread from its original Leptomeningeal
DISEASE site to the arachnoid mater and the pia mater, the two Neoplasm
innermost layers of tissue that cover the brain and spinal
cord.
page 402 of 1925

DSSOUT (Disease Outcome)
C102578 DSSOUT
Code Value
C102600 BACTERIOLOGICAL CURE There are no indicators of bacterial infection in an Bacteriological Cure
individual who previously had an infection.
C102601 BACTERIOLOGICAL There are indicators of bacterial infection in the individual Bacteriological Failure
FAILURE who previously had an infection.
C102607 CLINICAL CURE There are no signs or symptoms of disease in the Clinical Cure
individual who previously had a disease.
C102608 CLINICAL FAILURE There are still signs or symptoms of disease in the Clinical Failure
individual who previously had an infection.
C38155 RECURRENT DISEASE Recurrent Disease The return of a disease after a period of remission. Recurrent Disease
page 403 of 1925

DTDECOD (Device Tracking and Disposition Event Dictionary Derived Term)
C112037 DTDECOD
Code Value
C101231 DEPLOYED The act of instantiating, positioning or activating a Medical Device

medical device inside of the body. Deployment
C112270 DESTROYED A finding referring to a product that has been demolished. Destroyed Medical Device
C114146 EXPLANTED A status indicating that a device is removed from a Explanted Medical Device
surgically or naturally formed cavity of the human body.
C80457 IMPLANTED A status indicating that a device is placed into a surgically Implanted Medical Device
or naturally formed cavity of the human body.
C117758 INTENDED BUT NOT A status indicating that a device was introduced to the Device Intended But Not
USED subject for use but did not meet its intended goal and Used
was removed. (NCI)
C112329 LOST A finding referring to a product that is no longer held or Lost Medical Device
possessed; incapable of being recovered or regained.
C25639 RECEIVED Coming into possession of or acting as the receptacle or Receive

recipient of an item conveyed by an intermediary to the
intended destination, from a sender.
C40353 SHIPPED Being transported or conveyed by an intermediary to a Shipping

destination, from the sender to the intended receiver.
page 404 of 1925

DTHDX (SDTM Death Diagnosis and Details Test Name)
C116107 DTHDX
Code Value
C135383 Age at Death Age at Death The age at which death occurred. (NCI) Age at Death
C135384 Autopsy Indicator Autopsy Indicator An indication as to whether an autopsy was performed. Autopsy Indicator
(NCI)
C135385 Death Certificate Death Certificate An indication as to whether a death certificate was Death Certification
Obtained Indicator Obtained Indicator obtained. (NCI) Indicator
C135386 Hospital Medical Record Hospital Medical Record An indication as to whether a hospital medical record was Hospital Medical Record
Obtained Ind Obtained Ind;Hospital obtained. Indicator
Medical Record Obtained
Indicator
C124331 Location of Death Location of Death The physical location at which the subject ceased to live. Location of Death
C99531 Primary Cause of Death Primary Cause of Death The primary significant event which ultimately led to Primary Cause of Death
death.
C116142 Secondary Cause of Secondary Cause of The secondary significant event which ultimately led to Secondary Cause of
Death Death death. Death
page 405 of 1925

DTHDXCD (SDTM Death Diagnosis and Details Test Code)
C116108 DTHDXCD
Code Value
C135383 AGEDTH Age at Death The age at which death occurred. (NCI) Age at Death
C135384 AUTOPIND Autopsy Indicator An indication as to whether an autopsy was performed. Autopsy Indicator
(NCI)
C135385 DTHCOIND Death Certificate An indication as to whether a death certificate was Death Certification
Obtained Indicator obtained. (NCI) Indicator
C135386 HMROIND Hospital Medical Record An indication as to whether a hospital medical record was Hospital Medical Record
Obtained Ind;Hospital obtained. Indicator
Medical Record Obtained
Indicator
C124331 LOCDTH Location of Death The physical location at which the subject ceased to live. Location of Death
C99531 PRCDTH Primary Cause of Death The primary significant event which ultimately led to Primary Cause of Death
death.
C116142 SECDTH Secondary Cause of The secondary significant event which ultimately led to Secondary Cause of
Death death. Death
page 406 of 1925

DURS (Device-In-Use Response)
C129938 DURS
Code Value
C130058 2-DIMENSIONAL BIPLANE An ultrasound imaging setting that uses a probe with two 2-Dimensional Biplane
MODE 2-dimensional (2D) planes set perpendicularly to each Ultrasound Mode
other, allowing for better detection and localization of
objects/structures.
C130059 2-DIMENSIONAL SINGLE An ultrasound imaging setting that uses a linear pattern 2-Dimensional Single
PLANE MODE of beams to produce a standard, 2-dimensional (2-D) Plane Ultrasound Mode
image.
C130060 3-DIMENSIONAL MODE An ultrasound imaging setting that reconstructs planar 3-Dimensional Ultrasound
ultrasound data into three dimensional images of the Mode
structure being scanned.
C130061 COLOR TISSUE DOPPLER Color Flow Tissue Doppler An ultrasound imaging setting that uses pulsed wave Color Tissue Doppler
MODE Mode Doppler signals to depict tissue motion direction and Ultrasound Mode
velocity in color images that are superimposed over
normal, 2-dimensional (2-D) images.
C130062 CONTINUOUS-WAVE CW Doppler;Continuous An ultrasound imaging setting that uses Doppler signals Continuous-Wave Doppler
DOPPLER MODE Doppler Mode that are continuously sent and received along a single Ultrasound Mode
line to measure both direction and velocity of blood flow.
C130063 M-MODE Motion Mode An ultrasound imaging setting that uses a single M-Mode Ultrasound Mode
ultrasound beam to provide high temporal resolution of
tissue motion.
C130064 PULSED-WAVE DOPPLER PW Doppler;Pulsed An ultrasound imaging setting that uses intermittent Pulsed-Wave Doppler
MODE Doppler Mode Doppler signals to measure both direction and velocity of Ultrasound Mode
blood flow.
C130065 PULSED-WAVE TISSUE Pulsed Tissue Doppler An ultrasound imaging setting that uses pulsed wave Pulsed-Wave Tissue
DOPPLER MODE Mode Doppler signals to measure velocity of tissue movement. Doppler Ultrasound Mode
C130066 TISSUE DOPPLER MODE An ultrasound imaging setting that uses intermittent Tissue Doppler
Doppler signals to measure velocity of tissue movement. Ultrasound Mode
page 407 of 1925

DUTEST (Device-In-Use Test Name)
C106482 DUTEST
Code Value
C102516 Anatomical Plane Anatomical Plane The position and orientation of the image slice relative to Image Plane
the patient-based coordinate system. (NCI)
C94862 Attenuation Correction Attenuation Correction The adjustment for the effect of tissue thicknesses Attenuation Correction
Type Type through which gamma's travel from an activity
concentration origin to the scanner's detectors. The count
rates of a detector are adjusted to values as if there were
no attenuation along the gamma's path. This makes
possible accurate quantitation in image analysis. (NCI)
C117759 Checkerboard Square Checkerboard Square A visual stimulus that uses a checkerboard pattern which Checkerboard Square
Size Size reverses every half-second (or other specified frequency). Size
The check size can be changed to allow for testing of
specific segments of the visual pathway.
C106510 Coil Strength Coil Strength The maximum voltage allowable to pass through an Coil Strength
electromagnetic coil. (NCI)
C142236 Continuous Audio Continuous Audio An indication as to whether a continuous audio recording Continuous Audio
Recording Indicator Recording Indicator is made during the assessment. Recording Made Indicator
C116127 Decay Correction Decay Correction An indication as to whether the image reconstruction took Decay Correction
Indicator Indicator into account the time-activity curve during which the Indicator
radiolabeled tracer decayed as it spread through the body
during the image acquisition.
C82331 Echo Time Echo Time The time in milliseconds between the application of the Echo Time
excitation pulse and the recording of the peak echo
signal. (NCI)
C74298 Field of View Field of View The extent of an area that is visible. (NCI) Field of View
C73792 Flip Angle Flip Angle In magnetic resonance imaging, the rotation of the Flip Angle
average axis of the protons, relative to the main
magnetic field direction, induced by radiofrequency
signals. (NCI)
C116126 Image Acquisition Image Acquisition The number of dimensions that the acquired image(s) are Image Acquisition
Dimensionality Dimensionality presented in. Dimensionality
C106533 Image Acquisition Matrix Image Acquisition Matrix A measurement of the number of data fields, pixels or Image Acquisition Matrix
Size Size data points assigned to each linear dimension in a digital Size
image. (NCI)
C116122 Image Weighting Type Image Weighting Type A classification of the technique used to enhance image Image Weighting Type
contrast based on differences in magnetic resonance
tissue properties. This can be achieved by changing the
echo time or repetition time after the tissue has returned
to its equilibrium state.
C116123 Interslice Distance Interslice Distance A measurement of the distance between slices within an Interslice Distance
image sequence, calculated by subtracting the nominal Measurement
slice thickness from the couch increment.
C116124 Inversion Time Inversion Time The time between the inversion and excitation pulses in Inversion Time
an inversion recovery pulse sequence.
C112364 Number of Coil Channels Number of Coil Channels The number of channels, or elements, in the coil Number of Coil Channels
component of the device.
C154906 Number of ECG Number of ECG The number of electrocardiogram electrodes used in the Number of
Electrodes Electrodes;Number of assessment. Electrocardiogram
EKG Electrodes;Number Electrodes
of Electrocardiogram
Electrodes
C154713 Number of EEG Number of EEG The number of electroencephalogram electrodes used in Number of
Electrodes Electrodes;Number of the assessment. Electroencephalogram
Electroencephalogram Electrodes
Electrodes
C154908 Number of EMG Number of EMG The number of electromyogram electrodes used in the Number of
Electrodes Electrodes;Number of assessment. Electromyogram
Electromyogram Electrodes
Electrodes
C154907 Number of EOG Number of EOG The number of electrooculogram electrodes used in the Number of
Electrodes Electrodes;Number of assessment. Electrooculogram
Electrooculogram Electrodes
Electrodes
page 408 of 1925

C106482 DUTEST
Code Value
C116125 Number of Slices Number of Slices The number of planar cross-sections in an imaging Number of Slices
sequence; each slice corresponds to a single image.
C142237 Pulse Oximeter Indicator Pulse Oximeter Indicator An indication as to whether a pulse oximeter is used in Pulse Oximeter Use
the assessment. Indicator
C106562 Pulse Sequence Pulse Sequence A serially recurrent arrangement of radiofrequency pulses Pulse Sequence
that are applied to the sample. (NCI)
C116128 Randoms Correction Randoms Correction An indication as to whether the device was set to correct Randoms Correction
Indicator Indicator for random noise generated by deflected positrons. Indicator
C106563 Receiver Bandwidth Receiver Bandwidth The range between the minimum and maximum cut-off Receiver Bandwidth
frequencies for a particular receiver, commonly measured
in Hertz. (NCI)
C106564 Reconstruction Filter Type Reconstruction Filter Type A classification of the reconstruction filter used to Reconstruction Filter Type
suppress noise, enhance edges, resolution recovery and
smooth an image.
C111303 Reconstruction of Raw Reconstruction of Raw The type of mathematical process used to produce the Reconstruction of Raw
Data Type Data Type displayed image from the raw k-space data obtained from Data Type
the receiver circuitry. (NCI)
C154716 Reference Equation Reference Equation A mathematical formula to predict measured outcomes Reference Equation
based on values of associated parameters determined to
be related to a test. Reference equations are typically
derived via regression analysis of parameters postulated
to be relevant to the outcome over sample cohorts from
large populations, and verified by comparing measured
outcomes to predictions over out-of-sample cohorts.
C82330 Repetition Time Repetition Time The amount of time in milliseconds between successive Repetition Time
pulse sequences applied to the same slice.
C112416 Signal Amplitude Signal Amplitude A measurement of the height of the signal. Signal Amplitude
C112417 Signal Frequency Signal Frequency A measurement of the number of cycles of a periodic Signal Frequency
wave or pulse per unit of time.
C112418 Signal Width Signal Width A measurement of the range of values seen in the time Signal Width
interval between the beginning and end of the pulse
wave.
C111314 Slice Number Slice Number The numeric identifier used to identify an image slice. Slice Number
(NCI)
C106534 Slice Thickness Slice Thickness The dimension between two surfaces of an imaging plane. Image Slice Thickness
(NCI)
C111093 Software Version Software Version A form or variant of software; one of a sequence of Software Version
C114145 Stimulation Parameter Stimulation Parameter The type of electrode (monopolar or bipolar) used on the Electrical Stimulation
subject during electrical stimulation of the body or organ. Electrode Type
C130045 Ultrasound Mode Ultrasound Mode The image acquisition settings of an ultrasound-based Ultrasound Mode
imaging modality, based on parameters including
transducer design, ultrasound frequency, and ultrasound
signal processing.
C69201 X-axis Pixel Spacing X-axis Pixel Spacing A measurement of the distance between the centers of Horizontal Pixel Spacing
two adjacent pixels located along the X-axis.
C69210 Y-axis Pixel Spacing Y-axis Pixel Spacing A measurement of the distance between the centers of Vertical Pixel Spacing
two adjacent pixels located along the Y-axis.
page 409 of 1925

DUTESTCD (Device-In-Use Test Code)
C106483 DUTESTCD
Code Value
C102516 ANTPLANE Anatomical Plane The position and orientation of the image slice relative to Image Plane
the patient-based coordinate system. (NCI)
C106533 AQMTRXSZ Image Acquisition Matrix A measurement of the number of data fields, pixels or Image Acquisition Matrix
Size data points assigned to each linear dimension in a digital Size
image. (NCI)
C94862 ATTCRCT Attenuation Correction The adjustment for the effect of tissue thicknesses Attenuation Correction
Type through which gamma's travel from an activity
concentration origin to the scanner's detectors. The count
rates of a detector are adjusted to values as if there were
no attenuation along the gamma's path. This makes
possible accurate quantitation in image analysis. (NCI)
C142236 CAUDRIND Continuous Audio An indication as to whether a continuous audio recording Continuous Audio
Recording Indicator is made during the assessment. Recording Made Indicator
C117759 CHCKSIZE Checkerboard Square A visual stimulus that uses a checkerboard pattern which Checkerboard Square
Size reverses every half-second (or other specified frequency). Size
The check size can be changed to allow for testing of
specific segments of the visual pathway.
C112364 COILNUM Number of Coil Channels The number of channels, or elements, in the coil Number of Coil Channels
component of the device.
C106510 COILSTR Coil Strength The maximum voltage allowable to pass through an Coil Strength
electromagnetic coil. (NCI)
C116127 DECCORR Decay Correction An indication as to whether the image reconstruction took Decay Correction
Indicator into account the time-activity curve during which the Indicator
radiolabeled tracer decayed as it spread through the body
during the image acquisition.
C154906 ECGELCTN Number of ECG The number of electrocardiogram electrodes used in the Number of
Electrodes;Number of assessment. Electrocardiogram
EKG Electrodes;Number Electrodes
of Electrocardiogram
Electrodes
C82331 ECHOTIME Echo Time The time in milliseconds between the application of the Echo Time
excitation pulse and the recording of the peak echo
signal. (NCI)
C154713 EEGELCTN Number of EEG The number of electroencephalogram electrodes used in Number of
Electrodes;Number of the assessment. Electroencephalogram
Electroencephalogram Electrodes
Electrodes
C154908 EMGELCTN Number of EMG The number of electromyogram electrodes used in the Number of
Electrodes;Number of assessment. Electromyogram
Electromyogram Electrodes
Electrodes
C154907 EOGELCTN Number of EOG The number of electrooculogram electrodes used in the Number of
Electrodes;Number of assessment. Electrooculogram
Electrooculogram Electrodes
Electrodes
C74298 FLDVIEW Field of View The extent of an area that is visible. (NCI) Field of View
C73792 FLIPANGL Flip Angle In magnetic resonance imaging, the rotation of the Flip Angle
average axis of the protons, relative to the main
magnetic field direction, induced by radiofrequency
signals. (NCI)
C116126 IMAQDIM Image Acquisition The number of dimensions that the acquired image(s) are Image Acquisition
Dimensionality presented in. Dimensionality
C116122 IMWGTTYP Image Weighting Type A classification of the technique used to enhance image Image Weighting Type
contrast based on differences in magnetic resonance
tissue properties. This can be achieved by changing the
echo time or repetition time after the tissue has returned
to its equilibrium state.
C116123 INTDISTM Interslice Distance A measurement of the distance between slices within an Interslice Distance
image sequence, calculated by subtracting the nominal Measurement
slice thickness from the couch increment.
C116124 INVRTIME Inversion Time The time between the inversion and excitation pulses in Inversion Time
an inversion recovery pulse sequence.
page 410 of 1925

C106483 DUTESTCD
Code Value
C116125 NUMSLICE Number of Slices The number of planar cross-sections in an imaging Number of Slices
sequence; each slice corresponds to a single image.
C69201 PIXSPCX X-axis Pixel Spacing A measurement of the distance between the centers of Horizontal Pixel Spacing
two adjacent pixels located along the X-axis.
C69210 PIXSPCY Y-axis Pixel Spacing A measurement of the distance between the centers of Vertical Pixel Spacing
two adjacent pixels located along the Y-axis.
C142237 PULOXIND Pulse Oximeter Indicator An indication as to whether a pulse oximeter is used in Pulse Oximeter Use
the assessment. Indicator
C106562 PULSSEQ Pulse Sequence A serially recurrent arrangement of radiofrequency pulses Pulse Sequence
that are applied to the sample. (NCI)
C116128 RANDCORR Randoms Correction An indication as to whether the device was set to correct Randoms Correction
Indicator for random noise generated by deflected positrons. Indicator
C106563 RCBDWDTH Receiver Bandwidth The range between the minimum and maximum cut-off Receiver Bandwidth
frequencies for a particular receiver, commonly measured
in Hertz. (NCI)
C106564 RCFLTRTP Reconstruction Filter Type A classification of the reconstruction filter used to Reconstruction Filter Type
suppress noise, enhance edges, resolution recovery and
smooth an image.
C111303 RECONDAT Reconstruction of Raw The type of mathematical process used to produce the Reconstruction of Raw
Data Type displayed image from the raw k-space data obtained from Data Type
the receiver circuitry. (NCI)
C154716 REFEQU Reference Equation A mathematical formula to predict measured outcomes Reference Equation
based on values of associated parameters determined to
be related to a test. Reference equations are typically
derived via regression analysis of parameters postulated
to be relevant to the outcome over sample cohorts from
large populations, and verified by comparing measured
outcomes to predictions over out-of-sample cohorts.
C82330 REPTIME Repetition Time The amount of time in milliseconds between successive Repetition Time
pulse sequences applied to the same slice.
C111093 SFTWRVER Software Version A form or variant of software; one of a sequence of Software Version
C112416 SIGAMP Signal Amplitude A measurement of the height of the signal. Signal Amplitude
C112417 SIGFREQ Signal Frequency A measurement of the number of cycles of a periodic Signal Frequency
wave or pulse per unit of time.
C112418 SIGW Signal Width A measurement of the range of values seen in the time Signal Width
interval between the beginning and end of the pulse
wave.
C111314 SLICNUM Slice Number The numeric identifier used to identify an image slice. Slice Number
(NCI)
C106534 STHICK Slice Thickness The dimension between two surfaces of an imaging plane. Image Slice Thickness
(NCI)
C114145 STIMPARM Stimulation Parameter The type of electrode (monopolar or bipolar) used on the Electrical Stimulation
subject during electrical stimulation of the body or organ. Electrode Type
C130045 ULTRMODE Ultrasound Mode The image acquisition settings of an ultrasound-based Ultrasound Mode
imaging modality, based on parameters including
transducer design, ultrasound frequency, and ultrasound
signal processing.
page 411 of 1925

EBFATS (Ebola Virus Findings About Test Name)
C132315 EBFATS
Code Value
C25285 Diameter Diameter The length of a straight line passing through the center of Diameter
a circle or sphere and connecting two points on the
circumference. (NCI)
C127786 Occurrence Indicator Occurrence Indicator An indication as to whether something has happened, Occurrence Indicator
C25676 Severity/Intensity Severity/Intensity The degree of something undesirable. Severity
page 412 of 1925

EBFATSCD (Ebola Virus Findings About Test Code)
C132316 EBFATSCD
Code Value
C25285 DIAMETER Diameter The length of a straight line passing through the center of Diameter
a circle or sphere and connecting two points on the
circumference. (NCI)
C127786 OCCUR Occurrence Indicator An indication as to whether something has happened, Occurrence Indicator
C25676 SEV Severity/Intensity The degree of something undesirable. Severity
page 413 of 1925

ECOG1TC (Eastern Cooperative Oncology Group Performance Status Questionnaire Test Code)
C101815 ECOG1TC
Code Value
C102408 ECOG101 ECOG1-Performance ECOG Performance Status - Performance Status. ECOG - Performance
Status Status
page 414 of 1925

ECOG1TN (Eastern Cooperative Oncology Group Performance Status Questionnaire Test Name)
C101816 ECOG1TN
Code Value
C102408 ECOG1-Performance ECOG1-Performance ECOG Performance Status - Performance Status. ECOG - Performance
Status Status Status
page 415 of 1925

ED1TC (Expanded Disability Rating Scale - Postacute Interview Caregiver Version Questionnaire Test
Code)
C125745 ED1TC
Code Value
C125773 ED102_1 ED1-Able to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Communicate Clearly Caregiver Version - Is [name] able to communicate with Caregiver Version - Able
you in a way that you and others clearly understand? to Communicate Clearly
C125774 ED102_2 ED1-How They Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Communicate Primarily Caregiver Version - How do they communicate primarily? Caregiver Version - How
They Communicate
Primarily
C125775 ED102_3 ED1-Correct Date and Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Time Caregiver Version - Is [name] able to give the correct Caregiver Version - Give
date and time within a few seconds of being asked? Correct Date and Time
When Asked
C125776 ED102_4 ED1-Few Words or Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Random Caregiver Version - Does [name] have only a few words Caregiver Version - Use
Answers/Shouting that [s/he] uses over and over or does [s/he] express Few Words or Random
him/herself only through random answers, shouting or Shouting
swearing?
C125777 ED102_5 ED1-Moan/Groan/Sounds Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Not Understandable Caregiver Version - Does [name] only moan, groan or Caregiver Version - Make
make other sounds that are not understandable? Sounds Not
Understandable
C125778 ED104_1 ED1-Feed Independently Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Without Help Caregiver Version - Can [name] feed him/herself Caregiver Version - Feed
independently or manage tube feedings appropriately Independently Without
without help or reminders? Help
C125779 ED104_2 ED1-Understand Feeding Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Utensils Caregiver Version - Does [name] understand what eating Caregiver Version -
or feeding utensils or equipment are for and how they Understand Feeding
should be used? Utensils
C125780 ED104_3 ED1-Know Meal Times Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Caregiver Version - Does [name] know when meal or Caregiver Version - Know
feeding times are? Meal Times
C125781 ED105_1 ED1-Use Toilet Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Caregiver Version - Can [name] use the toilet or manage Caregiver Version - Use
their bowel and bladder routine independently and Toilet Independently
appropriately without help or reminders?
C125782 ED105_2 ED1-Manage Clothing Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
When Toileting Caregiver Version - Does [name] understand how to Caregiver Version -
manage their clothing or special equipment when toileting Manage Clothing When
or in bowel and bladder management? Toileting
C125783 ED105_3 ED1-Know When to Use Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Toilet Caregiver Version - Does [name] know when to use the Caregiver Version - Know
toilet or to conduct bowel and bladder management? When to Use Toilet
C125784 ED106_1 ED1-Can Dress/Groom Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Caregiver Version - Can [name] dress and groom Caregiver Version - Can
him/herself independently and appropriately or direct Dress and Groom Self
someone else in these activities without help or Independently
reminders?
C125785 ED106_2 ED1-Know How to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Bathe/Wash Caregiver Version - Does [s/he] know how to bathe and Caregiver Version - Know
wash? How to Bathe and Wash
C125786 ED106_3 ED1-Understand How to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Get Dressed Caregiver Version - Does [s/he] understand how to get Caregiver Version -
dressed? Understand How to Get
Dressed
C125787 ED106_4 ED1-Start/Finish Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Grooming Activities Caregiver Version - Can [s/he] start and finish these Caregiver Version - Start
grooming activities without prompting? and Finish Grooming
Activities
C125788 ED107_1 ED1-Function Completely Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Caregiver Version - Does [name] function completely Caregiver Version -
independently? That is, [s/he] does not require any Function Completely
physical assistance, supervision, equipment, devices or Independently
reminders for cognitive, social, behavioral, emotional, and
physical function?
page 416 of 1925

C125745 ED1TC
Code Value
C125789 ED107_2 ED1-Require Specific Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Aids/Equipment Caregiver Version - Does [name] REQUIRE special aids or Caregiver Version -
equipment such as a brace, walker, wheelchair, memory Require Special Aids or
notebook, day planner, verbal reminders, prompts, cues, Equipment
or alarm watch because of a disability?
C125790 ED107_3 ED1-Require Physical Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Assistance Caregiver Version - Does [name] require physical Caregiver Version -
assistance from another person to meet daily needs? Require Physical
Assistance
C125791 ED107_4 ED1-Require Assistance Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Thinking Tasks Caregiver Version - Does [s/he] require assistance from Caregiver Version -
another person in tasks that require thinking abilities? Require Assistance
Thinking Tasks
Managing Emotions Caregiver Version - Does [s/he] require assistance from Caregiver Version -
another person to manage emotions and behavior? Require Assistance
Managing Emotions
C125793 ED107_6A ED1-Need a Helper Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Always Close By Caregiver Version - Does [s/he] take care of some of Caregiver Version - Need
their needs but also need a helper who is always close a Helper Always Close By
by?
C125794 ED107_6B ED1-Need Help With All Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Major Activities Caregiver Version - Does [s/he] need help with all major Caregiver Version - Need
activities and the assistance of another person all the Help With All Major
time? Activities
C125795 ED107_6C ED1-Need 24-Hour Care Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Caregiver Version - Does [s/he] need 24-hour care and is Caregiver Version - Need
not able to help with their own care at all? 24-Hour Care
C125796 ED108_1 ED1-Independent Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Work/Social Situations Caregiver Version - Can [name] function with complete Caregiver Version -
independence in work or social situations? Function With
Independent Work or
Social Situations
C125797 ED108_2 ED1-Understand/Follow Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Directions Caregiver Version - Can [name] understand, remember, Caregiver Version -
and follow directions? Understand and Follow
Directions
C125798 ED108_3 ED1-Keep Track of Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Time/Schedules Caregiver Version - Can [name] keep track of time, Caregiver Version - Keep
schedules and appointments? Track of Time
C125799 ED108_4 ED1-Perform Jobs, Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Manage Home/School Caregiver Version - How certain are you that [name] can Caregiver Version -
perform in a wide variety of jobs of [his/her] choosing or Perform Jobs or Manage a
manage a home independently or participate in school Home Independently
full-time?
C125800 ED108_5 ED1-Successful With Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Accommodations Caregiver Version - How certain are you that [name] can Caregiver Version -
be successful at work, school or in home management Successful With
with some reduction in the work load or with other Accommodations
accommodations due to disabilities?
Limited Choices Caregiver Version - How certain are you that [name] can Caregiver Version -
be successful at work, school or in home management Successful With Limited
but with limited choices in jobs or school courses due to Choices
disabilities?
C125802 ED108_7 ED1-Work With Frequent Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Support Caregiver Version - How certain are you that [name] can Caregiver Version - Work
be able to work at home or in a special setting like a With Frequent
sheltered workshop in which the work is very routine and Supervision and Support
there is very frequent supervision and support?
page 417 of 1925

ED1TN (Expanded Disability Rating Scale - Postacute Interview Caregiver Version Questionnaire Test
Name)
C125744 ED1TN
Code Value
C125773 ED1-Able to ED1-Able to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Communicate Clearly Communicate Clearly Caregiver Version - Is [name] able to communicate with Caregiver Version - Able
you in a way that you and others clearly understand? to Communicate Clearly
C125784 ED1-Can Dress/Groom ED1-Can Dress/Groom Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Independently Caregiver Version - Can [name] dress and groom Caregiver Version - Can
him/herself independently and appropriately or direct Dress and Groom Self
someone else in these activities without help or Independently
reminders?
C125775 ED1-Correct Date and ED1-Correct Date and Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Time Time Caregiver Version - Is [name] able to give the correct Caregiver Version - Give
date and time within a few seconds of being asked? Correct Date and Time
When Asked
C125778 ED1-Feed Independently ED1-Feed Independently Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Without Help Without Help Caregiver Version - Can [name] feed him/herself Caregiver Version - Feed
independently or manage tube feedings appropriately Independently Without
without help or reminders? Help
C125776 ED1-Few Words or ED1-Few Words or Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Random Random Caregiver Version - Does [name] have only a few words Caregiver Version - Use
Answers/Shouting Answers/Shouting that [s/he] uses over and over or does [s/he] express Few Words or Random
him/herself only through random answers, shouting or Shouting
swearing?
C125788 ED1-Function Completely ED1-Function Completely Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Independently Caregiver Version - Does [name] function completely Caregiver Version -
independently? That is, [s/he] does not require any Function Completely
physical assistance, supervision, equipment, devices or Independently
reminders for cognitive, social, behavioral, emotional, and
physical function?
C125774 ED1-How They ED1-How They Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Communicate Primarily Communicate Primarily Caregiver Version - How do they communicate primarily? Caregiver Version - How
They Communicate
Primarily
C125796 ED1-Independent ED1-Independent Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Work/Social Situations Work/Social Situations Caregiver Version - Can [name] function with complete Caregiver Version -
Independent Work or
Social Situations
C125798 ED1-Keep Track of ED1-Keep Track of Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Time/Schedules Time/Schedules Caregiver Version - Can [name] keep track of time, Caregiver Version - Keep
schedules and appointments? Track of Time
C125785 ED1-Know How to ED1-Know How to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Bathe/Wash Bathe/Wash Caregiver Version - Does [s/he] know how to bathe and Caregiver Version - Know
wash? How to Bathe and Wash
C125780 ED1-Know Meal Times ED1-Know Meal Times Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Caregiver Version - Does [name] know when meal or Caregiver Version - Know
feeding times are? Meal Times
C125783 ED1-Know When to Use ED1-Know When to Use Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Toilet Toilet Caregiver Version - Does [name] know when to use the Caregiver Version - Know
toilet or to conduct bowel and bladder management? When to Use Toilet
C125782 ED1-Manage Clothing ED1-Manage Clothing Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
When Toileting When Toileting Caregiver Version - Does [name] understand how to Caregiver Version -
manage their clothing or special equipment when toileting Manage Clothing When
or in bowel and bladder management? Toileting
C125777 ED1-Moan/Groan/Sounds ED1-Moan/Groan/Sounds Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Not Understandable Not Understandable Caregiver Version - Does [name] only moan, groan or Caregiver Version - Make
make other sounds that are not understandable? Sounds Not
Understandable
C125795 ED1-Need 24-Hour Care ED1-Need 24-Hour Care Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Caregiver Version - Does [s/he] need 24-hour care and is Caregiver Version - Need
not able to help with their own care at all? 24-Hour Care
C125793 ED1-Need a Helper ED1-Need a Helper Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Always Close By Always Close By Caregiver Version - Does [s/he] take care of some of Caregiver Version - Need
their needs but also need a helper who is always close a Helper Always Close By
by?
page 418 of 1925

C125744 ED1TN
Code Value
C125794 ED1-Need Help With All ED1-Need Help With All Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Major Activities Major Activities Caregiver Version - Does [s/he] need help with all major Caregiver Version - Need
time? Activities
C125799 ED1-Perform Jobs, ED1-Perform Jobs, Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Manage Home/School Manage Home/School Caregiver Version - How certain are you that [name] can Caregiver Version -
perform in a wide variety of jobs of [his/her] choosing or Perform Jobs or Manage a
full-time?
C125792 ED1-Require Assistance ED1-Require Assistance Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Managing Emotions Managing Emotions Caregiver Version - Does [s/he] require assistance from Caregiver Version -
Managing Emotions
Thinking Tasks Thinking Tasks Caregiver Version - Does [s/he] require assistance from Caregiver Version -
Thinking Tasks
C125790 ED1-Require Physical ED1-Require Physical Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Assistance Assistance Caregiver Version - Does [name] require physical Caregiver Version -
assistance from another person to meet daily needs? Require Physical
Assistance
C125789 ED1-Require Specific ED1-Require Specific Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Aids/Equipment Aids/Equipment Caregiver Version - Does [name] REQUIRE special aids or Caregiver Version -
equipment such as a brace, walker, wheelchair, memory Require Special Aids or
C125787 ED1-Start/Finish ED1-Start/Finish Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Grooming Activities Grooming Activities Caregiver Version - Can [s/he] start and finish these Caregiver Version - Start
Activities
C125800 ED1-Successful With ED1-Successful With Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Accommodations Accommodations Caregiver Version - How certain are you that [name] can Caregiver Version -
be successful at work, school or in home management Successful With
with some reduction in the work load or with other Accommodations
Limited Choices Limited Choices Caregiver Version - How certain are you that [name] can Caregiver Version -
be successful at work, school or in home management Successful With Limited
but with limited choices in jobs or school courses due to Choices
disabilities?
C125779 ED1-Understand Feeding ED1-Understand Feeding Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Utensils Utensils Caregiver Version - Does [name] understand what eating Caregiver Version -
or feeding utensils or equipment are for and how they Understand Feeding
C125786 ED1-Understand How to ED1-Understand How to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Get Dressed Get Dressed Caregiver Version - Does [s/he] understand how to get Caregiver Version -
Dressed
C125797 ED1-Understand/Follow ED1-Understand/Follow Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Directions Directions Caregiver Version - Can [name] understand, remember, Caregiver Version -
and follow directions? Understand and Follow
Directions
C125781 ED1-Use Toilet ED1-Use Toilet Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Independently Caregiver Version - Can [name] use the toilet or manage Caregiver Version - Use
their bowel and bladder routine independently and Toilet Independently
C125802 ED1-Work With Frequent ED1-Work With Frequent Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Support Support Caregiver Version - How certain are you that [name] can Caregiver Version - Work
be able to work at home or in a special setting like a With Frequent
page 419 of 1925

ED2TC (Expanded Disability Rating Scale - Postacute Interview Survivor Version Questionnaire Test
Code)
C125747 ED2TC
Code Value
C125803 ED202_3 ED2-Correct Date and Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Time Survivor Version - Are you able to give the correct date Survivor Version - Give
and time within a few seconds of being asked? Correct Date and Time
When Asked
C125804 ED204_1 ED2-Feed Independently Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Without Help Survivor Version - Can you feed yourself independently or Survivor Version - Feed
manage tube feedings appropriately without help or Yourself Independently
reminders? Without Help
C125805 ED204_2 ED2-Understand Feeding Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Utensils Survivor Version - Do you understand what eating or Survivor Version -
feeding utensils or equipment are for and how they Understand Feeding
C125806 ED204_3 ED2-Know Meal Times Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Survivor Version - Do you know when meal or feeding Survivor Version - Know
times are? Meal Times
C125807 ED205_1 ED2-Use Toilet Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Survivor Version - Can you use the toilet or manage your Survivor Version - Use
bowel and bladder routine independently and Toilet Independently
C125808 ED205_2 ED2-Manage Clothing Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
When Toileting Survivor Version - Do you understand how to manage Survivor Version -
your clothing or special equipment when toileting or in Manage Clothing When
bowel and bladder management? Toileting
C125809 ED205_3 ED2-Know When to Use Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Toilet Survivor Version - Do you know when to use the toilet or Survivor Version - Know
to conduct bowel and bladder management? When to Use Toilet
C125810 ED206_1 ED2-Can Dress/Groom Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Survivor Version - Can you dress and groom yourself Survivor Version - Can
independently and appropriately or direct someone else in Dress and Groom Self
these activities without help or reminders? Independently
C125811 ED206_2 ED2-Know How to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Bathe/Wash Survivor Version - Do you know how to bathe and wash? Survivor Version - Know
How to Bathe and Wash
C125812 ED206_3 ED2-Understand How to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Get Dressed Survivor Version - Do you understand how to get Survivor Version -
Dressed
C125813 ED206_4 ED2-Start/Finish Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Grooming Activities Survivor Version - Can you start and finish these Survivor Version - Start
Activities
C125814 ED207_1 ED2-Function Completely Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Survivor Version - Do you function completely Survivor Version -
independently? That is, you do not require any physical Function Completely
assistance, supervision, equipment, devices, or reminders Independently
for cognitive, social, behavioral, emotional, and physical
function?
C125815 ED207_2 ED2-Require Specific Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Aids/Equipment Survivor Version - Do you REQUIRE special aids or Survivor Version -
equipment, such as, a brace, walker, wheelchair, memory Require Special Aids or
C125816 ED207_3 ED2-Require Physical Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Assistance Survivor Version - Do you require physical assistance Survivor Version -
from another person to meet daily needs? Require Physical
Assistance
Thinking Tasks Survivor Version - Do you require assistance from Survivor Version -
Thinking Tasks
Managing Emotions Survivor Version - Do you require assistance from Survivor Version -
Managing Emotions
page 420 of 1925

C125747 ED2TC
Code Value
C125819 ED207_6A ED2-Need a Helper Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Always Close By Survivor Version - Do you take care of some of your Survivor Version - Need a
needs but also need a helper who is always close by? Helper Always Close By
C125820 ED207_6B ED2-Need Help With All Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Major Activities Survivor Version - Do you need help with all major Survivor Version - Need
time? Activities
C125821 ED207_6C ED2-Need 24-Hour Care Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Survivor Version - Do you need 24-hour care and are not Survivor Version - Need
able to help with your own care at all? 24-Hour Care
C125822 ED208_1 ED2-Independent Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Work/Social Situations Survivor Version - Can you function with complete Survivor Version -
Independent Work or
Social Situations
C125823 ED208_2 ED2-Understand/Follow Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Directions Survivor Version - Can you understand, remember, and Survivor Version -
follow directions? Understand and Follow
Directions
C125824 ED208_3 ED2-Keep Track of Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Time/Schedules Survivor Version - Can you keep track of time, schedules Survivor Version - Keep
and appointments? Track of Time
C125825 ED208_4 ED2-Perform Jobs, Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Manage Home/School Survivor Version - How certain are you that you can Survivor Version -
perform in a wide variety of jobs of your choosing or Perform Jobs or Manage a
full-time?
Accommodations Survivor Version - How certain are you that you can be Survivor Version -
successful at work, school or in home management with Successful With
some reduction in the work load or with other Accommodations
Limited Choices Survivor Version - How certain are you that you can be Survivor Version -
successful at work, school or in home management but Successful With Limited
with limited choices in jobs or school courses due to Choices
disabilities?
C125828 ED208_7 ED2-Work With Frequent Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Support Survivor Version - How certain are you that you can be Survivor Version - Work
able to work at home or in a special setting like a With Frequent
page 421 of 1925

ED2TN (Expanded Disability Rating Scale - Postacute Interview Survivor Version Questionnaire Test
Name)
C125746 ED2TN
Code Value
C125810 ED2-Can Dress/Groom ED2-Can Dress/Groom Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Independently Survivor Version - Can you dress and groom yourself Survivor Version - Can
independently and appropriately or direct someone else in Dress and Groom Self
these activities without help or reminders? Independently
C125803 ED2-Correct Date and ED2-Correct Date and Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Time Time Survivor Version - Are you able to give the correct date Survivor Version - Give
and time within a few seconds of being asked? Correct Date and Time
When Asked
C125804 ED2-Feed Independently ED2-Feed Independently Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Without Help Without Help Survivor Version - Can you feed yourself independently or Survivor Version - Feed
manage tube feedings appropriately without help or Yourself Independently
reminders? Without Help
C125814 ED2-Function Completely ED2-Function Completely Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Independently Survivor Version - Do you function completely Survivor Version -
independently? That is, you do not require any physical Function Completely
assistance, supervision, equipment, devices, or reminders Independently
for cognitive, social, behavioral, emotional, and physical
function?
C125822 ED2-Independent ED2-Independent Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Work/Social Situations Work/Social Situations Survivor Version - Can you function with complete Survivor Version -
Independent Work or
Social Situations
C125824 ED2-Keep Track of ED2-Keep Track of Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Time/Schedules Time/Schedules Survivor Version - Can you keep track of time, schedules Survivor Version - Keep
and appointments? Track of Time
C125811 ED2-Know How to ED2-Know How to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Bathe/Wash Bathe/Wash Survivor Version - Do you know how to bathe and wash? Survivor Version - Know
How to Bathe and Wash
C125806 ED2-Know Meal Times ED2-Know Meal Times Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Survivor Version - Do you know when meal or feeding Survivor Version - Know
times are? Meal Times
C125809 ED2-Know When to Use ED2-Know When to Use Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Toilet Toilet Survivor Version - Do you know when to use the toilet or Survivor Version - Know
to conduct bowel and bladder management? When to Use Toilet
C125808 ED2-Manage Clothing ED2-Manage Clothing Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
When Toileting When Toileting Survivor Version - Do you understand how to manage Survivor Version -
your clothing or special equipment when toileting or in Manage Clothing When
bowel and bladder management? Toileting
C125821 ED2-Need 24-Hour Care ED2-Need 24-Hour Care Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Survivor Version - Do you need 24-hour care and are not Survivor Version - Need
able to help with your own care at all? 24-Hour Care
C125819 ED2-Need a Helper ED2-Need a Helper Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Always Close By Always Close By Survivor Version - Do you take care of some of your Survivor Version - Need a
needs but also need a helper who is always close by? Helper Always Close By
C125820 ED2-Need Help With All ED2-Need Help With All Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Major Activities Major Activities Survivor Version - Do you need help with all major Survivor Version - Need
time? Activities
C125825 ED2-Perform Jobs, ED2-Perform Jobs, Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Manage Home/School Manage Home/School Survivor Version - How certain are you that you can Survivor Version -
perform in a wide variety of jobs of your choosing or Perform Jobs or Manage a
full-time?
Managing Emotions Managing Emotions Survivor Version - Do you require assistance from Survivor Version -
Managing Emotions
Thinking Tasks Thinking Tasks Survivor Version - Do you require assistance from Survivor Version -
Thinking Tasks
page 422 of 1925

C125746 ED2TN
Code Value
C125816 ED2-Require Physical ED2-Require Physical Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Assistance Assistance Survivor Version - Do you require physical assistance Survivor Version -
from another person to meet daily needs? Require Physical
Assistance
C125815 ED2-Require Specific ED2-Require Specific Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Aids/Equipment Aids/Equipment Survivor Version - Do you REQUIRE special aids or Survivor Version -
equipment, such as, a brace, walker, wheelchair, memory Require Special Aids or
C125813 ED2-Start/Finish ED2-Start/Finish Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Grooming Activities Grooming Activities Survivor Version - Can you start and finish these Survivor Version - Start
Activities
Accommodations Accommodations Survivor Version - How certain are you that you can be Survivor Version -
successful at work, school or in home management with Successful With
some reduction in the work load or with other Accommodations
Limited Choices Limited Choices Survivor Version - How certain are you that you can be Survivor Version -
successful at work, school or in home management but Successful With Limited
with limited choices in jobs or school courses due to Choices
disabilities?
C125805 ED2-Understand Feeding ED2-Understand Feeding Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Utensils Utensils Survivor Version - Do you understand what eating or Survivor Version -
feeding utensils or equipment are for and how they Understand Feeding
C125812 ED2-Understand How to ED2-Understand How to Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Get Dressed Get Dressed Survivor Version - Do you understand how to get Survivor Version -
Dressed
C125823 ED2-Understand/Follow ED2-Understand/Follow Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Directions Directions Survivor Version - Can you understand, remember, and Survivor Version -
follow directions? Understand and Follow
Directions
C125807 ED2-Use Toilet ED2-Use Toilet Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Independently Independently Survivor Version - Can you use the toilet or manage your Survivor Version - Use
bowel and bladder routine independently and Toilet Independently
C125828 ED2-Work With Frequent ED2-Work With Frequent Expanded Disability Rating Scale - Postacute Interview Expanded DRS-PI
Support Support Survivor Version - How certain are you that you can be Survivor Version - Work
able to work at home or in a special setting like a With Frequent
page 423 of 1925

EDSS01TC (Kurtzke Expanded Disability Status Scale Questionnaire Test Code)
C112439 EDSS01TC
Code Value
C112550 EDSS0101 EDSS01-Expanded Kurtzke Expanded Disability Status Scale - Expanded EDSS - Expanded
Disability Score disability score. Disability Score
page 424 of 1925

EDSS01TN (Kurtzke Expanded Disability Status Scale Questionnaire Test Name)
C112438 EDSS01TN
Code Value
C112550 EDSS01-Expanded EDSS01-Expanded Kurtzke Expanded Disability Status Scale - Expanded EDSS - Expanded
Disability Score Disability Score disability score. Disability Score
page 425 of 1925

EGLEAD (ECG Lead)
C90013 EGLEAD
Code Value
C90403 LEAD aV6 An augmented unipolar lead placed at the sixth Lead Site aV6
intercostal space on the midaxillary line. (NCI)
C90360 LEAD aVF An augmented unipolar electrocardiogram limb lead in Augmented Vector Foot
which the positive (red) electrode is situated on the left
pelvic limb and the negative electrode is a combination of
the right thoracic limb (white) electrode and the left
thoracic limb (black) electrode. Measures the electrical
activity of the electrode on the left pelvic limb.
C135387 LEAD aVF-VENTRAL An augmented unipolar electrocardiogram limb lead in Lead Site aVF-Ventral
which the positive electrode is situated at the
hindquarters proximal to the sacrum and the negative
electrode is a combination of the electrode behind the
right ear near the right mastoid process and the electrode
near the apex of the heart (located in the ICS of left 5-6
rib close to the sternum).
C90361 LEAD aVL An augmented unipolar electrocardiogram limb lead in Augmented Vector Left
which the positive (black) electrode is situated on the left
thoracic limb and the negative electrode is a combination
of the right thoracic limb (white) electrode and the left
pelvic limb (red) electrode. Measures the electrical
activity of the electrode on the left thoracic limb. (NCI)
C135388 LEAD aVL-AXIAL An augmented unipolar electrocardiogram limb lead in Lead Site aVL-Axial
which the positive electrode is near the apex of the heart
(located in the ICS of left 5-6 rib close to the sternum)
and the negative electrode is a combination of the
electrode behind the right ear near the right mastoid
process and the electrode on hindquarters proximal to the
sacrum.
C90362 LEAD aVR An augmented unipolar electrocardiogram limb lead in Augmented Vector Right
which the positive (white) electrode is situated on the
right thoracic limb and the negative electrode is a
combination of the left thoracic limb (black) electrode and
the left pelvic limb (red) electrode. Measures the
electrical activity of the electrode on the right thoracic
limb. (NCI)
C135389 LEAD aVR-DORSAL An augmented unipolar electrocardiogram limb lead in Lead Site aVR-Dorsal
which the positive electrode is behind the right ear near
the right mastoid process and the negative electrode is a
combination of the electrode at the hindquarters proximal
to the sacrum and the electrode near the apex of the
heart (located in the ICS of left 5-6 rib close to the
sternum).
C135390 LEAD AXIAL A bipolar electrocardiogram limb lead which records the Lead Site Axial
voltage between the positive electrode near the apex of
the heart (located in the ICS of left 5-6 rib close to the
sternum) and the negative electrode behind the right ear
near the right mastoid process.
C90404 LEAD CM5 A bipolar EKG lead with the right thoracic limb electrode Lead Site CM5
placed on the manubrium and left thoracic limb electrode
placed at the surface marking of the V5 position (just
above the 5th interspace in the anterior axillary line). The
left pelvic limb lead acts as a neutral and may be placed
anywhere. The C refers to 'clavicle' where it is often
placed. (NCI)
C90405 LEAD CV5RL A unipolar chest lead used mostly in large animals. Placed Lead Site CV5RL
on the sixth ICS on the right side of the thorax along a
line parallel to the level of the point of the humeralradial
joint.
C90406 LEAD CV6LL V1 electrode (+) placed in the 6th intercostal space on Lead Site CV6LL
the left side of the thorax along a line parallel to the level
of the point of the humeralradial joint.
C90407 LEAD CV6LU V2 electrode (+) placed in the 6th intercostal space on Lead Site CV6LU
the left side of the thorax along a line parallel to the level
of the point of the shoulder. (NCI)
C135391 LEAD DORSAL A bipolar electrocardiogram limb lead which records the Lead Site Dorsal
voltage between the negative electrode behind the right
ear near the right mastoid process and the positive
electrode on the hindquarters proximal to the sacrum.
page 426 of 1925

C90013 EGLEAD
Code Value
C90408 LEAD I A bipolar electrocardiogram limb lead which records the Lead Site I
voltage between the negative electrode on the right
thoracic limb and the positive electrode on the left
thoracic limb. (NCI)
C90409 LEAD II A bipolar electrocardiogram limb lead which records the Lead Site II
voltage between the negative electrode on the right
thoracic limb and the positive electrode on the left pelvic
limb. (NCI)
C90410 LEAD III A bipolar electrocardiogram limb lead which records the Lead Site III
voltage between the negative electrode on the left
thoracic limb and the positive electrode on the left pelvic
limb. (NCI)
C90411 LEAD rV2 A unipolar precordial lead placed at the second intercostal Lead Site rV2
space to the left of the sternum. (NCI)
C90412 LEAD V1 Lead C1 A unipolar electrocardiogram lead site; the electrode is Lead Site V1
placed at the fourth intercostal space on the anterior
chest wall (between ribs 4 and 5) to the right of the
sternal border. In small animals, it is placed at the right
fifth intercostal space near the sternum. (NCI)
C90413 LEAD V10 A unipolar chest lead at which the electrode is placed Lead Site V10
over the dorsal spinous process of 7th thoracic vertebra.
(NCI)
placed on the anterior chest wall at the fourth intercostal
space (between ribs 4 and 5) to the left of the sternal
border. In small animals it corresponds to V2-V3 where it
is placed at the 6th left intercostal space near the
sternum. In large animals it is placed over the 6th rib at
the level of the costochondral junction on the left side of
the thorax.
placed on the anterior chest wall midway between leads
V2 and V4. In large and small animals, it is placed over
the dorsal spinous process of the 7th thoracic vertebra.
(NCI)
placed at the fifth intercostal space on the anterior chest
wall (between ribs 5 and 6) at the left midclavicular line.
In small animals it corresponds to V4-V6 where it is
placed at the 6th left intercostal space near the
costochondral junction. In large animals it is placed over
the 6th rib at the level of a horizontal line drawn through
the scapulohumeral articulation on the left side of the
thorax. (NCI)
placed on the anterior chest wall level with lead V4 at the
left anterior axillary line. In large animals it is placed on
the sixth ICS on the right side of the thorax along a line
parallel to the level of the point of the shoulder
corresponding to the electrical center of the heart (central
terminal). (NCI)
C90418 LEAD V6 Lead C6 A unipolar electrocardiogram lead site at which the Lead Site V6
electrode is placed on the anterior chest wall level with
lead V5 at the left midaxillary line .
C135392 LEAD VENTRAL A bipolar electrocardiogram limb lead which records the Lead Site Ventral
voltage with the positive electrode on the hindquarters
proximal to the sacrum and the negative electrode near
the apex of the heart (located in the ICS of left 5-6 rib
close to the sternum).
C117760 SML Global Median Measurement methodology using multiple leads for the Superimposition of
Beat;Superimposition of determination of an ECG parameter. This is often visually Multiple Leads
Multiple Leads represented as a superimposition of the median beats
from multiple leads.
page 427 of 1925

EGMETHOD (ECG Test Method)
C71151 EGMETHOD
Code Value
C90349 10 LEAD STANDARD 10 Lead Standard An electrocardiogram lead placement on the subject using 10 Lead Standard
a ten electrode lead set to synthesize standard 12 lead
electrocardiograph data to elicit an electrical view of the
heart.
C71125 12 LEAD 1 LEAD MISSING 12 Lead 1 Lead Missing An electrocardiogram (ECG) lead placement whereby 12 12 Lead Placement 1
leadpoints are recorded but one standard lead position is Lead Missing
missing therefore requiring a Mortara source consistency
filter. (NCI)
C71116 12 LEAD CABRERA 12 Lead Cabrera An electrocardiogram (ECG) lead placement whereby the 12 Lead Placement
display of the 12 standard ECG leads is in an orderly Cabrera
sequence in a single horizontal display of: aVL, I, -aVR,
II, aVF, III, V1 to V6. In the Cabrera display the limb lead
aVR is inverted (-aVR) to obtain the same positive
leftward orientation as the other 5 limbs. (NCI)
C123444 12 LEAD CONTINUOUS A continuous electrocardiographic (ECG) recording 12 Lead Continuous ECG
ECG utilizing 12 leads. The positioning of the electrodes may
vary from the standard 12 lead ECG placement. Examples
include but are not limited to 12 lead Holter with modified
Mason-Likar lead placements, 12 lead exercise ECGs, and
12 lead telemetry systems.
C71123 12 LEAD EASI DOWER 12 Lead EASI Dower An electrocardiogram (ECG) lead placement whereby 4 Lead Placement EASI
TRANSFORMATION Transformation chest electrodes and 1 reference electrode are used to Dower Transformation
allow for continuous monitoring at the clinical level. This
placement creates a 12 lead ECG that allows the
acquisition of simultaneous events in the frontal,
horizontal and sagittal heart planes with the linear
transformation of vectors. This system provides a three-
dimensional portrayal of the heart and uses mathematical
and fixed coefficients for each lead. (NCI)
C123445 12 LEAD ECG EXTRACTED A standard duration (typically 10 seconds) 12 lead 12 Lead ECG Extracted
FROM 12 LEAD electrocardiogram (ECG) extracted from a 12 lead From 12 Lead Continuous
CONTINUOUS ECG continuous ECG. ECG Recording
RECORDING
C71103 12 LEAD MASON LIKAR 12 Lead Mason Likar An electrocardiogram (ECG) lead placement whereby 12 12 Lead Placement Mason
leadpoints are recorded but the standard lead positions Likar
have been modified for ECG recording during exercise.
Exercise stress testing requires moving the limb
electrodes to more central positions on the thorax. The
electrodes are placed in bony prominences close to the
bases of the respective limbs in order to avoid skeletal
muscle artifact, provide stability for recording electrodes
and to record waveforms similar to the standard limb
sites. (NCI)
C71110 12 LEAD MODIFIED 12 Lead Modified Mason An electrocardiogram (ECG) lead placement whereby 12 12 Lead Placement Mason
MASON LIKAR Likar leadpoints are recorded but the Mason Likar lead Likar Modified
positions have been modified so that V1 to V6 on the
chest are part of a single electrode pad. In addition, lead
CM5 is substituted for lead aVR. (NCI)
C71114 12 LEAD NON-STANDARD 12 Lead Non-Standard An electrocardiogram (ECG) lead placement whereby the 12 Lead Placement Non-
limb leads are placed on the torso for easier and faster Standard
application in emergency situations. (NCI)
C116139 12 LEAD RIGHT-SIDED 12 Lead Right-sided An electrocardiogram (ECG) lead placement whereby the 12 Lead Placement Right-
PRECORDIAL LEADS Precordial Leads;Right- precordial leads are intentionally placed on the right side sided Precordial Leads
sided Chest Leads of the chest.
C71112 12 LEAD SINGLE PAD 12 Lead Single Pad An electrocardiogram (ECG) lead placement whereby 12 12 Lead Placement Chest
leadpoints are recorded but the standard lead positions
have been modified so that all leads on the chest are part
of a single electrode pad. (NCI)
page 428 of 1925

C71151 EGMETHOD
Code Value
C71102 12 LEAD STANDARD 12 Lead Standard An electrocardiogram (ECG) lead placement whereby 12 12 Lead Placement
leads are recorded, with each lead representing an Standard
electrical view of the heart. The six leads recorded in the
frontal plane are derived from the placement of 3
electrodes (RA or Right Arm, LA, or Left Arm, and LL or
Left Leg). These bipolar frontal leads form the basis of
Einthoven's triangle, and are represented by leads I, II,
and III. Three other derived (or augmented) bipolar
frontal vectors are also recorded on a standard 12-lead
EKG, aVR, aVF, and aVL. 6 unipolar leads, corresponding
to V1 - V6 measure the electrical activity in the horizontal
plane. The placement for the V leads is as follows: V1:
right 4th intercostal space,V2: left 4th intercostal space,
V3: halfway between V2 and V4, V4: left 5th intercostal
space, mid-clavicular line, V5: horizontal to V4, anterior
axillary line, V6: horizontal to V5, mid-axillary line. (NCI)
C71101 12 LEAD UNSPECIFIED 12 Lead Unspecified An electrocardiogram (ECG) lead placement whereby 12 12 Lead Placement
leadpoints are recorded but the position of the leads is Unspecified
unspecified. (NCI)
C132355 6 LEAD NEHB-SPORI An electrocardiogram (ECG) lead configuration that is 6 Lead NEHB-SPORI
primarily used to record ECGs in non-human animals, and
which uses six (6) electrodes to generate eight (8) ECG
leads (ECG wave forms). The six electrode configuration
includes the following: four (4) limb electrodes, which are
placed analogous to an Einthoven configuration in
humans, and two (2) chest electrodes. The eight (8) ECG
leads recorded comprise three standard limb leads (leads
I, II, and III), three augmented leads (Leads aVR, aVF,
and aVL), and two chest leads, which are generated using
two unipolar chest leads, typically CV5RL [rV2] and
CV6LL [V2] for canines, or MV1 and MV2 for primates.
C90350 6 LEAD STANDARD 6 Lead Standard An electrocardiogram lead placement on the subject using 6 Lead Standard
a six electrode lead set with three standard leads and
three augmented derived leads to elicit an electrical view
of the heart.
C132356 8 LEAD STANDARD An electrocardiogram (ECG) recorded using 6 electrodes 8 Lead Standard
to generate 8 ECG leads (ECG wave forms). The 6
electrode configuration includes 4 limb electrodes in an
Einthoven configuration and two chest electrodes. The 8
ECG leads recorded consist of three standard limb leads
(leads I, II, and III), three augmented leads (leads aVR,
aVF, and aVL), and two chest leads (which are generated
using two unipolar chest leads (typically CV5RL [rV2] and
CV6LL [V2] for canines or MV1 and MV2 for non-human
primates). This lead configuration is typically used to
record ECGs in non-human animals.
C71121 BIPOLAR UNCORRECTED Bipolar uncorrected XYZ An electrocardiogram (ECG) lead placement whereby the Lead Placement Bipolar
XYZ LEAD SYSTEM lead system X+ lead is placed at the right mid-axillary line ate the 4th Uncorrected XYZ
intercostal space, X- at the left mid-axillary line at he 4th
intercostal space, Y+ at the proximal left leg, Y- at the
superior aspect of the manubrium, Z+ at the direct
posterior to Z- and Z- at the 4th intercostal space at the
left sternal margin. (NCI)
C123446 CONTINUOUS A continuous electrocardiographic (ECG) recording Continuous Ambulatory

AMBULATORY ECG utilizing 1 or more leads that records and stores data ECG
directly to the device. The subject need not be restricted
to a medical facility, and may be able to participate in
their customary activities of daily living.
C154718 CONTINUOUS ECG A continuous electrocardiographic (ECG) recording Continuous ECG

RECORDING FOR NON- utilizing one or more implanted leads in a non-human Recording for Non-human
HUMAN SPECIES USING species. Species Using Implanted
IMPLANTED LEADS Leads
C154717 CONTINUOUS SURFACE A continuous electrocardiographic (ECG) recording Continuous Surface ECG
ECG RECORDING FOR utilizing one or more surface leads in a non-human Recording for Non-human
NON-HUMAN SPECIES species. Species
C71120 CUBE LEAD SYSTEM Cube lead system An electrocardiogram (ECG) lead placement that is a type Lead Placement Cube
of uncorrected vectorcardiograph. This lead system is
based on a rectangular body axis. It uses an extra
number of electrodes to make it three-dimensional. (NCI)
page 429 of 1925

C71151 EGMETHOD
Code Value
C71118 FRANK LEAD SYSTEM Frank lead system An electrocardiogram (ECG) lead placement for Lead Placement Frank
determining 3 orthogonal components X (right to left
direction), Y (foot to head direction) and Z (back to front
direction) of the heart. For this method a minimum of 4
electrodes are needed that represent the right arm, left
arm, left leg and back. However, usually 7 electrodes are
used to avoid dependence on the dipole location and
facilitate interpretation. (NCI)
C38064 HOLTER CONTINUOUS An electrocardiographic method for collecting continuous Holter Monitoring
ECG RECORDING ECG waveforms with a variable number of discrete leads
with duration longer than the standard 10 second ECG.
Holter recording may be performed in patients who are
ambulatory, and may collect data for 24 hours or longer.
C71119 MCFEE-PARUNGAO LEAD McFee-Parungao lead An electrocardiogram (ECG) lead placement for Lead Placement McFee-
SYSTEM system determining 3 orthogonal components X (back to front), Y Parungao
(right to left) and Z (foot to head) of the heart. This
system places the electrodes closer to the heart to
achieve better orthogonality and a homogeneous lead
field. (NCI)
C71122 PSEUDO-ORTHOGONAL Pseudo-orthogonal XYZ An electrocardiogram (ECG) lead placement that allows Lead Placement Pseudo
XYZ LEAD SYSTEM lead system monitoring and recording of cardiac electrical activity. A Orthogonal XYZ
V1-type lead is used whose positive electrode is localized
in the 4th intercostal space, 2.5cm from the sternum. Its
negative electrode is placed below the left clavicle. An
addition of lead V5 and aVF can be made to facilitate
interpretation. (NCI)
C71128 STANDARD 12-LEAD AND Standard 12-lead and An electrocardiogram (ECG) lead placement whereby 12 12 Lead Placement
CC5-CM5-ML CC5-CM5-ML leadpoints are recorded but the standard lead positions Standard And CC5-CM5-
have been modified so that the negative reference is at ML
CM5 and the active electrode is at the left leg position.
(NCI)
C71126 STANDARD 12-LEAD AND Standard 12-lead and An electrocardiogram (ECG) lead placement whereby 12 12 Lead Placement
CM5-CC5-CH5 CM5-CC5-CH5 leadpoints are recorded but the standard lead positions Standard And CC5-CM5-
have been modified so that the bipolar lead groups place CH5
the negative of the reference electrode over the
manubrium (CM5), the right scapula (CB5), V5R (CC5) or
on the forehead (CH5) and the active electrode at V5.
(NCI)
C71131 STANDARD 12-LEAD Standard 12-lead An electrocardiogram (ECG) lead placement whereby the 12 Lead Placement
EXTENDED LEFT extended to the left by standard lead placement is modified by having leads V7, Standard Extended Left
V7, V8, V9 V8 and V9. (NCI)
C71130 STANDARD 12-LEAD Standard 12-lead An electrocardiogram (ECG) lead placement whereby the 12 Lead Placement
EXTENDED RIGHT extended to the right by rightward oriented V leads progress from V1R, placed Standard Extended Right
V5R, V4R, V3R instead of the standard V2, to V6R. The V3 lead in the
standard placement is replaced by V4R. (NCI)
C71115 STANDARD LEADS FOR Limb leads on the back (shoulder and on the hips). (NCI) Lead Placement Bicycle
BICYCLE EXERCISE
C71117 STANDARD LEADS ONE Standard leads one An electrocardiographic lead placement schema in which Lead Placement Standard
INTERCOSTAL SPACE intercostal space higher the V leads are placed one intercostal space cephalad to Intercostal Space Higher
HIGHER the position they would have in the standard lead
placement schema. (NCI)
C71092 VECTORCARDIOGRAPH Vectorcardiograph A recording of the electrical activity of the heart displayed Vectorcardiograph
CORRECTED Corrected in the form of a vector loop, corrected for anatomic Corrected
inconsistencies. (NCI)
C71093 VECTORCARDIOGRAPH Vectorcardiograph A recording of the electrical activity of the heart displayed Vectorcardiograph
UNCORRECTED Uncorrected in the form of a vector loop, uncorrected for anatomic Uncorrected
inconsistencies. (NCI)
page 430 of 1925

EGSTRESC (ECG Result)
C71150 EGSTRESC
Code Value
C111088 1ST DEGREE AV BLOCK 1st degree AV block;PR An electrocardiographic finding of prolonged PR AV Block First Degree by
Prolongation;Prolonged PR interval for a specific population. For adults one ECG Finding
interval common threshold is a PR interval greater than 0.20
seconds. Note that other thresholds may be
applicable.
C71044 2:1 AV BLOCK 2:1 AV block An electrocardiographic finding of a supraventricular 2:1 Atrioventricular Block
rhythm where the ratio of impulses generated above by ECG Finding
the atrioventricular node to the number of impulses
conducted through to the ventricles is 2:1. This is
manifest on the ECG as 2 P waves per QRS
complex.
C62016 2ND DEGREE AV BLOCK Second Degree AV Block An electrocardiographic finding of intermittent AV Block Second Degree
failure of atrial electrical impulse conduction to the by ECG Finding
ventricles. This is manifest on the ECG by regular P
waves which intermittently are not followed by QRS
complexes.
C111091 3RD DEGREE AV BLOCK 3rd Degree Heart Block;AV An electrocardiographic finding of complete failure AV Block Third Degree by
block, complete (third- of atrial electrical impulse conduction to the ECG Finding
degree);Complete Heart Block ventricles. This is manifest on the ECG by
disassociation of atrial and ventricular rhythms. The
atrial rate must be faster than the ventricular rate.
C114165 50 Hz NOISE 50 Hz Artifact;50 Hz Noise An electrocardiographic recording showing power 50 Hertz Noise by ECG
line interference with the electrocardiographic Finding
signal. The artifact amplitude modulation has the
same frequency as the AC power system present
(50 Hz).
(60 Hz).
C116132 ABERRANTLY Aberrantly Conducted Beats An electrocardiographic finding of an abnormally Aberrantly Conducted
CONDUCTED COMPLEXES wide QRS complex(es) of supraventricular origin Complexes by ECG
with prolonged QRS duration due to aberrant AV Finding
conduction.
C114149 AC NOISE AC Noise An electrocardiographic recording showing power Alternating Current Noise
line interference with the electrocardiographic by ECG Finding
(usually 50 Hz or 60 Hz).
C62266 ACCELERATED Accelerated idioventricular An electrocardiographic finding of idioventricular Accelerated

IDIOVENTRICULAR rhythm rhythm with a rate greater than 50 beats per Idioventricular Rhythm by
RHYTHM minute. ECG Finding
C71065 ACUTE ANTERIOR WALL Acute Anterior MI;Acute An electrocardiographic finding of pathologic Q Acute Anterior Myocardial
MYOCARDIAL Anterior Wall Myocardial waves with accompanying ST elevation in leads V3 Infarction by ECG Finding
INFARCTION Infarction and V4, which is suggestive of acute myocardial
infarction of the anterior wall of the left ventricle.
C102591 ACUTE ANTEROLATERAL Acute Anterolateral Wall An electrocardiographic finding of pathologic Q Acute Anterolateral
WALL MYOCARDIAL Myocardial Infarction waves with accompanying ST elevation in leads V3 Myocardial Infarction by
INFARCTION through V6, which is suggestive of acute myocardial ECG Finding
infarction of the anterolateral wall of the left
ventricle.
C102592 ACUTE ANTEROSEPTAL Acute Anteroseptal Wall An electrocardiographic finding of pathologic Q Acute Anteroseptal
WALL MYOCARDIAL Myocardial Infarction;Acute waves with accompanying ST elevation in leads V1 Myocardial Infarction by
INFARCTION anteroseptal MI through V4, which is suggestive of acute myocardial ECG Finding
infarction of the anteroseptal wall of the left
ventricle.
C106496 ACUTE EXTENSIVE An electrocardiographic finding of pathologic Q Acute Extensive Anterior

ANTERIOR WALL waves with accompanying ST elevation in leads V1 Wall Myocardial Infarction
MYOCARDIAL to V6, I and aVL, which is suggestive of acute by ECG Finding
INFARCTION myocardial infarction involving the anterior and
anterolateral walls of the left ventricle.
C102593 ACUTE HIGH LATERAL Acute High Lateral Wall An electrocardiographic finding of pathologic Q Acute High Lateral
WALL MYOCARDIAL Myocardial Infarction waves with accompanying ST elevation in leads I Myocardial Infarction by
INFARCTION and aVL, which is suggestive of acute myocardial ECG Finding
infarction of the high lateral wall of the left ventricle.
page 431 of 1925

C71150 EGSTRESC
Code Value
C71066 ACUTE INFERIOR WALL Acute Inferior MI;Acute Inferior An electrocardiographic finding of pathologic Q Acute Inferior Myocardial
MYOCARDIAL Wall Myocardial Infarction waves with accompanying ST elevation in leads III, Infarction by ECG Finding
INFARCTION aVF and often II, which is suggestive of acute
myocardial infarction of the inferior wall of the left
ventricle.
C71067 ACUTE LATERAL WALL Acute Lateral MI;Acute Lateral An electrocardiographic finding of pathologic Q Acute Lateral Myocardial
MYOCARDIAL Wall Myocardial Infarction waves with accompanying ST elevation in leads V5, Infarction by ECG Finding
INFARCTION V6, I and aVL, which is suggestive of acute
myocardial infarction of the lateral wall of the left
ventricle.
C101596 ACUTE MYOCARDIAL Acute Myocardial Infarction An electrocardiographic finding showing a current of Acute Myocardial
INFARCTION injury with ST elevation. No specification is provided Infarction by ECG Finding
for localization.
C71068 ACUTE POSTERIOR WALL Acute Posterior MI;Acute An electrocardiographic finding in leads V1 or V2 of Acute Posterior
MYOCARDIAL Posterior Wall Myocardial an initial R wave duration greater than or equal to Myocardial Infarction by
INFARCTION Infarction 40 ms, R wave greater than S wave, upright T ECG Finding
wave, with accompanying ST elevation, which is
suggestive of acute myocardial infarction of the
posterior wall of the left ventricle. Evidence of
inferior or lateral myocardial infarction is usually
also present.
C102594 ACUTE RIGHT Acute Right Ventricular Wall An electrocardiographic finding in leads V1 or V2 of Acute Right Ventricular
VENTRICULAR WALL Myocardial Infarction;Acute an initial R wave duration greater than or equal to Myocardial Infarction by
MYOCARDIAL Right ventricular MI 40 ms, R wave greater than S wave, upright T ECG Finding
INFARCTION wave, with accompanying ST elevation, which is
ventricular wall of the left ventricle. Evidence of
also present. Additional criteria include ST elevation
> 100 microvolts in the right precordial leads V4R
through V6R.
C102595 ACUTE SEPTAL WALL Acute Septal Wall Myocardial An electrocardiographic finding of pathologic Q Acute Septal Myocardial
MYOCARDIAL Infarction waves with accompanying ST elevation in leads V1, Infarction by ECG Finding
INFARCTION V2 and often V3, which is suggestive of acute
myocardial infarction of the intraventricular septum.
C102642 ADVANCED/HIGH GRADE Advanced/High Grade AV Block An electrocardiographic finding of intermittent High Grade
AV BLOCK failure of atrial electrical impulse conduction to the Atrioventricular Block by
ventricles, characterized by two or more consecutive ECG Finding
non-conducted P waves.
C114159 ALL PRECORDIAL An electrocardiographic recording in which all All Precordial Electrodes
ELECTRODES precordial electrodes are disconnected resulting in Are Disconnected by ECG
DISCONNECTED missing waveforms (flat line) of all leads V1 - V6. Finding
C71069 ANTERIOR WALL Anterior MI;Anterior Wall An electrocardiographic finding of pathologic Q Anterior Myocardial
MYOCARDIAL Myocardial Infarction waves in leads V3 and V4, which is suggestive of Infarction by ECG Finding
INFARCTION myocardial infarction of the anterior wall of the left
ventricle.
C35303 ANTEROLATERAL WALL Anterolateral Wall Myocardial An electrocardiographic finding of pathologic Q Anterolateral Myocardial
MYOCARDIAL Infarction waves in leads V3 through V6, which is suggestive Infarction by ECG Finding
INFARCTION of myocardial infarction of the anterolateral wall of
the left ventricle.
C35304 ANTEROSEPTAL WALL Anteroseptal MI;Anteroseptal An electrocardiographic finding of pathologic Q Anteroseptal Myocardial
MYOCARDIAL Wall Myocardial Infarction waves in leads V1 through V4, which is suggestive Infarction by ECG Finding
INFARCTION of myocardial infarction of the anteroseptal wall of
the left ventricle.
C114162 ARTIFACT An electrocardiographic recording in which one or Artifact Lead Signal by

more leads display extraneous signals which do not ECG Finding
represent cardiac electrical activity.
C116130 ASYSTOLE An electrocardiographic finding showing no cardiac Asystole by ECG Finding

electrical activity on the ECG for the entire duration
of the recording.
C102596 ATRIAL BIGEMINY An electrocardiographic finding of a sinus beat Atrial Bigeminy by ECG
followed by a premature atrial complex for three or Finding
more consecutive cycles; a regularly irregular
rhythm of normal and abnormal P waves in a 1-1
ratio.
C102597 ATRIAL COUPLETS Atrial Couplets An electrocardiographic finding in which two Atrial Couplet by ECG
premature atrial complexes occur sequentially; Finding
there may be one or more occurrences during an
electrocardiographic recording.
page 432 of 1925

C71150 EGSTRESC
Code Value
C71039 ATRIAL ENLARGEMENT Atrial Enlargement An electrocardiographic finding which comprises left, Atrial Enlargement by
right or bilateral atrial enlargement. This is may be ECG Finding
characterized by prolonged P wave duration,
increased P wave amplitude, or multi-component P
waves.
C111092 ATRIAL FIBRILLATION Atrial fibrillation An electrocardiographic finding of a supraventricular Atrial Fibrillation by ECG
arrhythmia characterized by the replacement of Finding
consistent P waves by rapid oscillations or
fibrillatory waves that vary in size, shape and timing
and are accompanied by an irregularly irregular
ventricular response.
C111094 ATRIAL FLUTTER Atrial flutter An electrocardiographic finding of an organized, Atrial Flutter by ECG
regular atrial rhythm with atrial rate of 240-340 Finding
beats per minute. Multiple P waves typically appear
in the inferior leads in a saw tooth like pattern
between the QRS complexes.
C111105 ATRIAL TACHYCARDIA Atrial tachycardia An electrocardiographic finding of an organized, Atrial Tachycardia by ECG
regular atrial rhythm with atrial rate between 101 Finding
and 240 beats per minute. The P wave morphology
must be distinct from the sinus P wave morphology.
C119249 ATRIAL TACHYCARDIA An electrocardiographic finding of an atrial Atrial Tachycardia With

WITH AV BLOCK tachycardia which does not display 1:1 AV AV Block by ECG Finding
conduction.
C102598 ATRIAL TRIGEMINY Atrial Trigeminy An electrocardiographic finding of two sinus beats Atrial Trigeminy by ECG
followed by a premature atrial complex for 3 or Finding
ratio.
C71045 ATRIOVENTRICULAR AV Dissociation;Atrioventricular An electrocardiographic finding in which the Atrioventricular

DISSOCIATION dissociation electrical activity of the atria and ventricles are Dissociation by ECG
independent of one another. Finding
C111089 AV MOBITZ I AV Mobitz I;Mobitz I Second An electrocardiographic finding of intermittent AV Block Second Degree
Degree AV Block;Second failure of atrial electrical impulse conduction to the Mobitz Type I by ECG
degree AV block- Mobitz type ventricles, characterized by a progressively Finding
I;Second-degree AV block, lengthening PR interval prior to the block of an atrial
Mobitz type I impulse.
(Wenckebach);Type 1 2nd
degree AV Block;Wenckebach
C111090 AV MOBITZ II Mobitz II AV Block;Mobitz II An electrocardiographic finding of intermittent AV Block Second Degree
Second Degree AV Block;Type failure of atrial electrical impulse conduction to the Mobitz Type II by ECG
2 2nd degree AV Block ventricles, characterized by a relatively constant PR Finding
interval prior to the block of an atrial impulse.
C35058 AV NODE RE-ENTRY AV Node Reentrant An electrocardiographic finding of a regular Atrioventricular Nodal
Supraventricular Tachycardia supraventricular tachycardia due to reentry within Reentry Tachycardia by
the AV node. It is characterized by P waves which ECG Finding
typically occurs nearly simultaneously with the QRS
complex, resulting in a P wave which is obscured by
the QRS, merged with the QRS or which may follow
the QRS.
C62261 AV RE-ENTRANT AV Reentrant Supraventricular An electrocardiographic finding of a regular Atrioventricular Reentrant

TACHYCARDIA Tachycardia supraventricular tachycardia which utilizes an Tachycardia by ECG
atrioventricular bypass tract as its retrograde limb Finding
(orthodromic tachycardia) or as its antegrade limb
(antidromic tachycardia). QRS complexes during
sinus rhythm may show preexcitation. During
orthodromic tachycardia the preexcitation is not
present and a retrograde P wave may appear after
the QRS complex. During antidromic tachycardia the
QRS complex is preexcited.
C114147 BASELINE WANDER An electrocardiographic recording in which the Baseline Wander by ECG
isoelectric line in one or more leads is vertically Finding
displaced resulting in low frequency upward and
downward movements of the signal with varying
amplitudes.
C71046 BIFASCICULAR BLOCK Bifascicular block An electrocardiographic finding comprising right Bifascicular Block by ECG
bundle branch block and left anterior fascicular Finding
block, or right bundle branch block and left posterior
fascicular block. Defects occurring in two of the
three divisions of the conduction system of the heart
are considered bifascicular blocks. Technically left
bundle branch block may be considered a
bifascicular block. (NCI)
page 433 of 1925

C71150 EGSTRESC
Code Value
C106502 BIVENTRICULAR An electrocardiographic finding suggestive of Biventricular Hypertrophy

HYPERTROPHY enlargement or thickening of both ventricles, with a by ECG Finding
combination of findings which are related to LVH
and RVH, such as voltage criteria for LVH in the
presence of marked right axis deviation.
C92228 BORDERLINE QTCB Borderline QTcB An electrocardiographic finding in which the QT Borderline QTcB
interval corrected for heart rate using Bazett's
formula is slightly prolonged. Thresholds for
different age, gender, and patient populations exist.
C92229 BORDERLINE QTCF Borderline QTcF An electrocardiographic finding in which the QT Borderline QTcF
interval corrected for heart rate using Fridericia's
C111120 BRADYCARDIA Bradycardia An electrocardiographic finding of abnormally slow Bradycardia by ECG

heart rate. Thresholds for different age, gender, and Finding
patient populations exist.
C106503 BRUGADA SYNDROME An electrocardiographic finding of complete or Brugada Syndrome

PATTERN incomplete right bundle branch block accompanied Pattern by ECG Finding
by ST elevation in leads V1-V3. This may be noted
at rest or can be provoked by medication challenge.
C116138 CV ENDPOINTS An electrocardiographic finding, in the absence of ACC/AHA Ischemic ECG

ISCHEMIC ECG CHANGES left ventricular hypertrophy (LVH) and left bundle Changes
branch block pattern on ECG, of either a) new (or
presumed new) ST elevation at the J point in two
contiguous leads with the following cut-points:
greater than or equal to 0.1 mV in all leads other
than leads V2-V3 where the following cut points
apply: greater than or equal to 0.2 mV in men
greater than or equal to 40 years; greater than or
equal to 0.25 mV in men less than 40 years, or
greater than or equal to 0.15 mV in women; or b)
new (or presumed new) horizontal or down-sloping
ST depression greater than or equal to 0.05 mV in
two contiguous leads and/or T inversion greater
than or equal to 0.1 mV in two contiguous leads
with prominent R wave or R/S ratio greater than 1.
(Thygesen K, Alpert JS, Jaffe AS, Simoons ML, et
al.; Joint ESC/ACCF/AHA/WHF Task Force for
Universal Definition of Myocardial Infarction. Third
universal definition of myocardial infarction. J Am
Coll Cardiol. 2012 Oct 16;60(16):1581-98).
C62258 DELTA WAVE Delta wave An electrocardiographic finding of initial slurring Delta Wave by ECG
(delta wave) of the QRS complex due to the Finding
presence of an accessory pathway. This
characteristic ECG pattern is typically seen in Wolff-
Parkinson-White syndrome.
C102623 DEXTROCARDIA Dextrocardia An electrocardiographic finding suggestive of Dextrocardia by ECG

dextrocardia with situs inversus, characterized by Finding
reversal of normal anterior R wave progression and
the appearance of reversal of the right and left arm
electrodes.
C102628 EARLY R WAVE Early R Wave Progression;Early An electrocardiographic finding where the amplitude Early R Wave Transition
TRANSITION R Wave Transition of the R wave becomes greater than the amplitude by ECG Finding
of the S wave in the QRS complex at an unusually
early point in the precordial leads, usually in leads
V1 or V2.
C102629 EARLY REPOLARIZATION Early Repolarization An electrocardiographic finding of J point and ST Early Repolarization
segment elevation in the absence of other signs of
acute ischemia or pericarditis.
C114175 ECG ACQUIRED WITH An electrocardiographic recording in which the ECG Acquired with
PRECORDIAL precordial electrodes have been placed over the Precordial Electrodes
ELECTRODES PLACED ON right chest and record a right sided ECG. Placed on the Right Chest
RIGHT CHEST
C114181 ECG EVALUATION NOT A digital electrocardiographic recording which is ECG Evaluation Not
PERFORMED DUE TO corrupted (i.e. ECG signal cannot be restored) such Performed Due to
CORRUPTED DIGITAL that measurements and/or interpretation cannot be Corrupted Digital ECG File
ECG FILE performed.
C114180 ECG EVALUATION NOT A printed electrocardiographic recording with poor ECG Evaluation Not
PERFORMED DUE TO printout quality (e.g. a faded paper ECG tracing or Performed Due to Poor
POOR QUALITY OF ECG with inconsistent printing speed) such that Quality of Printed ECG
PRINTED ECG measurements and/or interpretation cannot be
performed.
page 434 of 1925

C71150 EGSTRESC
Code Value
C114178 ECG EVALUATION NOT An electrocardiographic recording in which ECG Evaluation Not
PERFORMED DUE TO measurements and/or interpretation are not Performed Due to
UNKNOWN ECG performed because the ECG amplitude gain and/or Unknown ECG Amplitude
AMPLITUDE GAIN OR recording speed are not known. Gain or Recording Speed
RECORDING SPEED
C62245 ECTOPIC ATRIAL RHYTHM Ectopic atrial rhythm An electrocardiographic finding of a regular atrial Ectopic Atrial Rhythm by
rhythm with atrial rate of less than 101 beats per ECG Finding
minute which does not originate in the sinus node,
and which is characterized by P waves whose
morphology differs from the P wave morphology
during sinus rhythm.
C71042 ECTOPIC VENTRICULAR Ectopic ventricular rhythm An electrocardiographic finding of three or more Ectopic Ventricular
RHYTHM consecutive complexes of ventricular origin. The Rhythm by ECG Finding
QRS complexes are wide and have an abnormal
morphology.
C71035 ELECTRICAL ALTERNANS Electrical alternans An electrocardiographic finding in which there is an Electrical Alternans by
alternating pattern of any of the waveform ECG Finding
components. (NCI)
C106520 EXTENSIVE ANTERIOR An electrocardiographic finding of pathologic Q Extensive Anterior Wall

WALL MYOCARDIAL waves in leads V1 to V6, I and aVL, which is Myocardial Infarction by
INFARCTION suggestive of myocardial infarction involving the ECG Finding
anterior and anterolateral walls of the left ventricle.
C102639 FUSION COMPLEX Fusion Beat;Fusion Complexes An electrocardiographic finding that occurs when Fusion Complex
electrical activation of the atria or ventricles occurs
from two separate sites. This results in a P wave or
QRS complex that displays merged characteristics of
beats originating from the two different sites; there
may be one or more occurrences during an
C102643 HIGH LATERAL WALL High Lateral Wall Myocardial An electrocardiographic finding of pathologic Q High Lateral Myocardial
MYOCARDIAL Infarction waves in leads I and aVL, which is suggestive of Infarction by ECG Finding
INFARCTION myocardial infarction of the high lateral wall of the
left ventricle.
C50599 IDIOVENTRICULAR Idioventricular Rhythm An electrocardiographic finding of three or more Idioventricular Rhythm
RHYTHM consecutive complexes of ventricular origin with a
rate less than a certain threshold (100 or 120 beats
per minute are commonly used). The QRS
complexes are wide and have an abnormal
morphology.
C114167 INCOMPLETE ECG An electrocardiographic recording which is limited in Incomplete ECG

duration or which does not display all of the
expected leads.
C71047 INCOMPLETE LEFT Incomplete left bundle branch An electrocardiographic finding of a wide QRS Incomplete Left Bundle
BUNDLE BRANCH BLOCK block complex with evidence of delayed conduction to the Branch Block by ECG
left ventricle, manifest as a widened initial portion of Finding
the QRS complex in leads V5, V6, I and aVL and
with QRS duration less than 120 ms.
C114179 INCOMPLETE An electrocardiographic recording in which Incomplete ECG

MEASUREMENTS DUE TO measurements (particularly of QRS amplitudes) Measurements Due to
TRUNCATION OF QRS and/or interpretations are not performed because Truncation of QRS
COMPLEXES QRS complexes have been truncated. Complexes
C71048 INCOMPLETE RIGHT Incomplete right bundle branch An electrocardiographic finding of a wide QRS Incomplete Right Bundle
BUNDLE BRANCH BLOCK block;Incomplete right bundle- complex with evidence of delayed conduction to the Branch Block by ECG
branch block right ventricle, manifest by a widened initial portion Finding
of the QRS in V1 and V2, a widened S wave in V5,
V6, I and aVL, and with QRS duration less than 120
ms.
C114169 INCOMPLETELY A digital electrocardiographic recording which was Incompletely Digitized

DIGITIZED ECG LEAD(S) digitized from paper ECG tracings and which does ECG Leads
not contain all leads present on the original paper
printout.
C114168 INCORRECTLY SCALED An electrocardiographic recording in which the ECG Incorrectly Scaled ECG
ECG signal is not displayed at the indicated recording
speed and/or amplitude resolution.
C102701 INDETERMINATE QRS Indeterminate An electrocardiographic finding in which the frontal QRS Axis Indeterminate
AXIS Axis;Indeterminate QRS plane QRS axis cannot be calculated.
Axis;QRS Axis Indeterminate
page 435 of 1925

C71150 EGSTRESC
Code Value
C35398 INFERIOR WALL Inferior MI;Inferior Wall An electrocardiographic finding of pathologic Q Inferior Myocardial
MYOCARDIAL Myocardial Infarction waves in leads III, aVF and often II, which is Infarction by ECG Finding
INFARCTION suggestive of myocardial infarction of the inferior
wall of the left ventricle.
C114177 INSUFFICENT NUMBER An electrocardiographic recording in which fewer Insufficient Number of

OF BEATS TO than the required number of cardiac complexes are Beats for Complete ECG
COMPLETELY EVALUATE available for measurement and/or interpretation due Evaluation
ECG to a shorter than planned recording or due to
cardiac complexes which are present but are not
suitable for measurement and/or interpretation.
C71073 INTRAATRIAL Intraatrial Conduction Delay An electrocardiographic finding of a delay in impulse Intra-Atrial Conduction
CONDUCTION DELAY propagation through the atria. This is characterized Delay by ECG Finding
by broad P waves which are often biphasic in V1.
C62271 INTRAVENTRICULAR Intraventricular Conduction An electrocardiographic finding of a widened QRS Nonspecific

CONDUCTION DELAY, Defect;Intraventricular duration typically greater than 110 ms which does Intraventricular
NONSPECIFIC conduction delay not meet the morphologic criteria for any of the Conduction Delay by ECG
standard bundle branch or fascicular block patterns. Finding
C114171 INVALID ECG An electrocardiographic recording for which the Invalid ECG Waveforms
WAVEFORMS displayed leads do not represent the individual's
true ECG lead information.
C62248 ISORHYTHMIC Isorhythmic dissociation An electrocardiographic finding of a type of Isorhythmic

DISSOCIATION atrioventricular dissociation characterized by the Atrioventricular
atria (P waves) and ventricles (QRS complexes) Dissociation
beating at similar rates, although independently.
C71030 J POINT ELEVATION J point elevation An electrocardiographic finding of a significant J Point Elevation
elevation above the baseline of the J point.
C71074 JUNCTIONAL Junctional bradycardia An electrocardiographic finding of a junctional Junctional Bradycardia by

BRADYCARDIA rhythm with a heart rate which is abnormally low. ECG Finding
C116129 JUNCTIONAL ESCAPE Junctional Escape An electrocardiographic finding of an escape beat Junctional Escape
COMPLEXES Beat;Junctional Escape following a pause which originates in the AV Complexes by ECG
Complex junction. This is manifest as a QRS complex of Finding
supraventricular origin not preceded by a P wave;
C135393 JUNCTIONAL ESCAPE An electrocardiographic finding of a junctional Junctional Escape Rhythm

RHYTHM rhythm that arises as a physiologic response to by ECG Finding
extreme slowing or arrest of sinus node activity. In
this setting, a faster junctional rhythm may be a
normal response to a very slow or absent sinus rate.
C102652 JUNCTIONAL PREMATURE Junctional Extra An electrocardiographic finding of an ectopic impulse Junctional Premature
COMPLEX Beat;Junctional Premature originating in the AV junction presenting as a QRS Complex by ECG Finding
Complexes complex of supraventricular origin which is not
preceded by a P wave; there may be one or more
occurrences during an electrocardiographic
recording.
C71051 JUNCTIONAL RHYTHM Junctional rhythm An electrocardiographic finding of a rhythm which Junctional Rhythm by
originates in the AV junction and results in a normal ECG Finding
heart rate. It is characterized by retrograde P waves
which may be obscured by or may follow the QRS
complexes. The QRS complexes may be narrow or
may demonstrate aberration.
C35059 JUNCTIONAL Junctional tachycardia An electrocardiographic finding of a junctional Junctional Tachycardia by

TACHYCARDIA rhythm with a heart rate which is abnormally ECG Finding
elevated.
C102653 LATE R WAVE Late R Wave Transition An electrocardiographic finding where the amplitude Late R Wave Transition
TRANSITION of the R wave does not become greater than the by ECG Finding
amplitude of the S wave until an unusually late
point in the precordial leads, usually in leads V4 to
V6.
C35586 LATERAL WALL Lateral MI;Lateral Wall An electrocardiographic finding of pathologic Q Lateral Myocardial
MYOCARDIAL Myocardial Infarction waves in leads V5, V6, I and aVL, which is Infarction by ECG Finding
INFARCTION suggestive of myocardial infarction of the lateral
C62267 LEFT ANTERIOR Left Anterior Hemiblock;Left An electrocardiographic finding of a slightly widened Left Anterior Fascicular
FASCICULAR BLOCK anterior fascicular block QRS duration (typically less than 120 ms) with Block by ECG Finding
leftward frontal plane QRS axis and typically small Q
waves in leads I and aVL.
page 436 of 1925

C71150 EGSTRESC
Code Value
C71040 LEFT ATRIAL Left Atrial Enlargement;P- An electrocardiographic finding suggesting P-mitrale by ECG Finding
ABNORMALITY mitrale underlying hypertrophy or dilatation of the left
atrium. Electrocardiographic criteria used for the
diagnosis of left atrial abnormality may include a
bifid p wave, a biphasic p wave and/or a p wave
duration of greater than 0.12 seconds. (NCI)
C62269 LEFT BUNDLE BRANCH Complete LBBB;Left bundle An electrocardiographic finding of a wide QRS Left Bundle Branch Block
BLOCK branch block;Left bundle- complex with evidence of delayed conduction to the by ECG Finding
branch block left ventricle, manifest as a widened initial portion of
with QRS duration greater than or equal to 120 ms.
C62268 LEFT POSTERIOR Left Posterior Hemiblock;Left An electrocardiographic finding of an S1Q3 pattern Left Posterior Fascicular
FASCICULAR BLOCK posterior fascicular block and QRS axis greater than or equal to 120 degrees. Block by ECG Finding
It is usually seen in association with other
abnormalities (e.g. RBBB or RVH).
C92231 LEFT VENTRICULAR Left Ventricular Conduction An electrocardiographic finding in which there is Left Ventricular
CONDUCTION DELAY Delay evidence that electrical transmission through the left Conduction Delay by ECG
ventricle is impaired. Finding
C71076 LEFT VENTRICULAR Left Ventricular Hypertrophy An electrocardiographic finding suggestive of a Left Ventricular
HYPERTROPHY hypertrophied left ventricle, characterized by large Hypertrophy by ECG
QRS amplitudes and secondary findings of left atrial Finding
enlargement, left axis deviation, or typical pattern
of ST depression and T wave inversion.
HYPERTROPHY WITH With Strain hypertrophied left ventricle, characterized by large Hypertrophy with Strain
STRAIN QRS amplitudes, ST depression and T wave by ECG Finding
inversion.
C114151 LIMB ELECTRODE(S) An electrocardiographic recording in which one or Disconnected Limb

DISCONNECTED more of the limb electrodes are disconnected Electrodes by ECG Finding
resulting in missing waveforms (often flat lines) of
the respective leads.
C114150 LIMB ELECTRODES Limb Lead Reversal An electrocardiographic recording in which two or Interchanged Limb
INTERCHANGED more of the limb electrodes are switched resulting in Electrodes by ECG Finding
improper representation of the affected leads.
C114166 LOW AMPLITUDE SIGNAL Low Amplitude QRS Complex An electrocardiographic recording showing smaller Low Amplitude QRS
than usual QRS complexes in one or more leads. Complex by ECG Finding
This may represent a technical issue with the ECG
acquisition or characteristics of the individual.
C71078 LOW QRS VOLTAGE Low QRS voltage An electrocardiographic finding of a QRS amplitude Low QRS Voltage by ECG
less than or equal to 0.5 mV in the limb leads or Finding
QRS amplitude less than or equal to 1 mV in the
precordial leads.
C116133 LOW VOLTAGE - LIMB An electrocardiographic finding of small QRS Low Voltage in Limb
LEADS ONLY amplitudes (less than 500 microvolts) in all limb Leads Only by ECG
leads. Finding
C71050 MULTIFOCAL ATRIAL Multifocal atrial tachycardia An electrocardiographic finding of a supraventricular Multifocal Atrial
TACHYCARDIA arrhythmia characterized by 3 or more distinct P Tachycardia by ECG
wave morphologies with an isoelectric baseline, Finding
variable PR intervals and no predominant atrial
rhythm. The ventricular rate is typically 100-150
beats per minute.
C114148 MUSCLE TREMOR An electrocardiographic recording with intermittent Muscle Tremor Artifact
mid to high frequency artifact in one or more leads
due to muscular tremor or movement rather than
cardiac activity.
C101589 MYOCARDIAL Myocardial Infarction An electrocardiographic finding of pathologic Q Myocardial Infarction by

INFARCTION waves, which is suggestive of myocardial infarction ECG Finding
of one or more regions of the heart. No specification
is provided for localization.
C102732 NEW ANTERIOR WALL New Anterior MI;New Anterior An electrocardiographic finding of pathologic Q New Anterior Myocardial
MYOCARDIAL Wall Myocardial Infarction waves in leads V3 and V4, which is suggestive of Infarction by ECG Finding
ventricle and which is new compared to prior ECGs.
C102733 NEW ANTEROLATERAL New Anterolateral Wall An electrocardiographic finding of pathologic Q New Anterolateral
WALL MYOCARDIAL Myocardial Infarction waves in leads V3 through V6, which is suggestive Myocardial Infarction by
INFARCTION of myocardial infarction of the anterolateral wall of ECG Finding
the left ventricle and which is new compared to prior
ECGs.
page 437 of 1925

C71150 EGSTRESC
Code Value
C102734 NEW ANTEROSEPTAL New Anteroseptal Wall An electrocardiographic finding of pathologic Q New Anteroseptal
INFARCTION of myocardial infarction of the anteroseptal wall of ECG Finding
ECGs.
C102735 NEW EXTENSIVE New Extensive Anterior Wall An electrocardiographic finding of pathologic Q New Extensive Anterior
ANTERIOR WALL Myocardial Infarction waves in leads V1 to V6, I and aVL, which is Myocardial Infarction by
MYOCARDIAL suggestive of myocardial infarction involving the ECG Finding
INFARCTION anterior and anterolateral walls of the left ventricle
and which is new compared to prior ECGs.
C102736 NEW HIGH LATERAL New High Lateral Wall An electrocardiographic finding of pathologic Q New High Lateral
WALL MYOCARDIAL Myocardial Infarction waves in leads I and aVL, which is suggestive of Myocardial Infarction by
INFARCTION myocardial infarction of the high lateral wall of the ECG Finding
left ventricle and which is new compared to prior
ECGs.
C102737 NEW INFERIOR WALL New Inferior Wall Myocardial An electrocardiographic finding of pathologic Q New Inferior Myocardial
MYOCARDIAL Infarction waves in leads III, aVF and often II, which is Infarction by ECG Finding
wall of the left ventricle and which is new compared
to prior ECGs.
C102738 NEW LATERAL WALL New Lateral Wall Myocardial An electrocardiographic finding of pathologic Q New Lateral Myocardial
MYOCARDIAL Infarction waves in leads V5, V6, I and aVL, which is Infarction by ECG Finding
to prior ECGs.
C102731 NEW MYOCARDIAL New Myocardial Infarction An electrocardiographic finding of pathologic Q New Myocardial Infarction
INFARCTION waves, which is suggestive of myocardial infarction by ECG Finding
of one or more regions of the heart and which is
new compared to prior ECGs. No specification is
provided for localization.
C106548 NEW POSTERIOR WALL An electrocardiographic finding in leads V1 or V2 of New Posterior Wall
MYOCARDIAL an initial R wave duration greater than or equal to Myocardial Infarction by
INFARCTION 40 ms, R wave greater than S wave, and upright T ECG Finding
wave, which is suggestive of myocardial infarction of
the posterior wall of the left ventricle, and which is
new compared to prior ECGs. Evidence of inferior or
lateral myocardial infarction is usually also present.
C102739 NEW SEPTAL WALL New Septal Wall Myocardial An electrocardiographic finding of pathologic Q New Septal Myocardial
MYOCARDIAL Infarction waves in leads V1, V2 and often V3, which is Infarction by ECG Finding
INFARCTION suggestive of myocardial infarction of the
intraventricular septum and which is new compared
to prior ECGs.
C114163 NO ECG WAVEFORMS An electrocardiographic recording that displays flat ECG Waveforms Not
PRESENT lines (no waveforms are visible) in all leads present. Present
C71080 NON Q WAVE Non Q Wave Myocardial An electrocardiographic finding of ST and T wave Non Q Wave Myocardial
MYOCARDIAL Infarction abnormalities in the absence of pathologic Q waves, Infarction by ECG Finding
INFARCTION which is suggestive of myocardial infarction in one
or more regions of the heart.
C116134 NON-DIAGNOSTIC Q An electrocardiographic finding of Q waves which Non-Diagnostic Q Waves

WAVES are insufficient for the diagnosis of myocardial by ECG Finding
infarction. In such cases a myocardial infarction may
be suspected, even though ECG criteria are not met.
C71031 NON-SPECIFIC ST-T Non-specific ST-T changes An electrocardiographic finding of changes in the ST Non-Specific ST-T
CHANGES segment and T wave that do not meet criteria for Changes by ECG Finding
ischemia or infarction. (NCI)
C102680 NON-SUSTAINED ATRIAL Non-Sustained Atrial An electrocardiographic finding of an atrial Non-Sustained Atrial
TACHYCARDIA Tachycardia tachycardia which terminates in less than 30 Tachycardia by ECG
seconds. Finding
C71053 NON-SUSTAINED Non-sustained ventricular An electrocardiographic finding of ventricular Non-Sustained

VENTRICULAR tachycardia;Ventricular tachycardia less than 30 seconds in duration. (NCI) Ventricular Tachycardia
TACHYCARDIA tachycardia, unsustained by ECG Finding
C135394 NONCONDUCTED P WAVE An electrocardiographic finding of a P wave that Nonconducted P Wave

PHYSIOLOGY NOT does not conduct to the ventricle or result in Physiology Not Defined by
DEFINED ventricular activation. ECG Finding
C102681 NORMAL SINUS RHYTHM Normal Sinus Rhythm An electrocardiographic finding of an atrial rhythm Normal Sinus Rhythm
which originates from the sinoatrial node that is
considered normal for the population. There are no
extra beats or conduction abnormalities.
page 438 of 1925

C71150 EGSTRESC
Code Value
C102634 NORTHWEST AXIS Northwest Axis;Right superior An electrocardiographic finding of a frontal plane Extreme Right Axis
axis QRS axis from -90 to +180 degrees. Deviation
C71032 NOTCHED T WAVES Notched T Waves An electrocardiographic finding of an irregular, u or T Wave Notched by ECG
v shaped deflection within the contour of the T Finding
wave.
C102684 OLD OR AGE Old Or Age Indeterminate An electrocardiographic finding of pathologic Q Old or Age Indeterminate
INDETERMINATE Anterior Wall Myocardial waves in leads V3 and V4, which is suggestive of Anterior Myocardial
ANTERIOR WALL Infarction myocardial infarction of the anterior wall of the left Infarction by ECG Finding
MYOCARDIAL ventricle, without evidence of current or ongoing
INFARCTION acute infarction.
INDETERMINATE Anterolateral Wall Myocardial waves in leads V3 through V6, which is suggestive Anterolateral Myocardial
ANTEROLATERAL WALL Infarction of myocardial infarction of the anterolateral wall of Infarction by ECG Finding
MYOCARDIAL the left ventricle, without evidence of current or
INFARCTION ongoing acute infarction.
INDETERMINATE Anteroseptal Wall Myocardial waves in leads V1 through V4, which is suggestive Anteroseptal Myocardial
ANTEROSEPTAL WALL Infarction of myocardial infarction of the anteroseptal wall of Infarction by ECG Finding
INDETERMINATE Extensive Anterior Wall waves in leads V1 to V6, I and aVL, which is Extensive Anterior
EXTENSIVE ANTERIOR Myocardial Infarction suggestive of myocardial infarction involving the Myocardial Infarction by
WALL MYOCARDIAL anterior and anterolateral walls of the left ventricle, ECG Finding
INFARCTION without evidence of current or ongoing acute
infarction.
C102688 OLD OR AGE Old Or Age Indeterminate High An electrocardiographic finding of pathologic Q Old or Age Indeterminate
INDETERMINATE HIGH Lateral Wall Myocardial waves in leads I and aVL, which is suggestive of High Lateral Myocardial
LATERAL WALL Infarction myocardial infarction of the high lateral wall of the Infarction by ECG Finding
MYOCARDIAL left ventricle, without evidence of current or ongoing
INDETERMINATE Inferior Wall Myocardial waves in leads III, aVF and often II, which is Inferior Myocardial
INFERIOR WALL Infarction suggestive of myocardial infarction of the inferior Infarction by ECG Finding
MYOCARDIAL wall of the left ventricle, without evidence of current
INFARCTION or ongoing acute infarction.
INDETERMINATE Lateral Wall Myocardial waves in leads V5, V6, I and aVL, which is Lateral Myocardial
LATERAL WALL Infarction suggestive of myocardial infarction of the lateral Infarction by ECG Finding
C102691 OLD OR AGE Old Or Age Indeterminate An electrocardiographic finding in leads V1 or V2 of Old or Age Indeterminate
INDETERMINATE Posterior Wall Myocardial an initial R wave duration greater than or equal to Posterior Myocardial
POSTERIOR WALL Infarction 40 ms, R wave greater than S wave, and upright T Infarction by ECG Finding
MYOCARDIAL wave, which is suggestive of myocardial infarction of
INFARCTION the posterior wall of the left ventricle, without
evidence of current or ongoing acute infarction.
Evidence of inferior or lateral myocardial infarction
is usually also present.
INDETERMINATE SEPTAL Septal Wall Myocardial waves in leads V1, V2 and often V3, which is Septal Myocardial
WALL MYOCARDIAL Infarction suggestive of myocardial infarction of the Infarction by ECG Finding
INFARCTION intraventricular septum, without evidence of current
or ongoing acute infarction.
C101597 OLD OR AGE Old Or Age Indeterminate Wall An electrocardiographic finding of pathologic Q Old Myocardial Infarction
INDETERMINATE WALL Myocardial Infarction waves, which is suggestive of myocardial infarction by ECG Finding
MYOCARDIAL of one or more regions of the heart, without
INFARCTION evidence of current or ongoing acute infarction. No
specification is provided for localization.
C102692 OLD OR AGE An electrocardiographic finding, in the presence of Old or Age Indeterminate
UNDETERMINED RIGHT an old or age indeterminate inferior wall myocardial Right Ventricular
VENTRICULAR infarction, of Q waves greater than or equal to 40 Myocardial Infarction by
MYOCARDIAL ms in duration in the right ventricular leads V4R ECG Finding
INFARCTION through V6R.
C114176 OTHER INCORRECT An electrocardiographic recording in which one or Other Incorrect Electrode
ELECTRODE PLACEMENT more electrodes are incorrectly placed but further Placement
details are not provided.
page 439 of 1925

C71150 EGSTRESC
Code Value
C90430 P WAVE ABNORMALITY P Wave Abnormality An electrocardiographic finding for the P wave that P Wave Abnormality by
is atypical either for the shape, duration, amplitude, ECG Finding
axis or polarity. Abnormality of the P wave signifies
aberrant propagation of the electrical impulse
through the atria. (NCI)
C90431 P WAVE NOTCHED P Wave Notched An electrocardiographic finding of P waves with two P Wave Notched by ECG
peaks longer in duration than normal and amplitude Finding
greater than normal.
C92232 PACED ATRIAL AND AV dual-paced complex(es) or An electrocardiographic finding in which both the Paced Atrial And
VENTRICULAR RHYTHM rhythm;Paced Atrial And atrial and ventricular rhythm are controlled by an Ventricular Rhythm
Ventricular Rhythm electrical impulse from an artificial cardiac
pacemaker.
C92233 PACED ATRIAL RHYTHM Atrial-paced complex(es) or An electrocardiographic finding in which the atrial Paced Atrial Rhythm
rhythm;Paced Atrial Rhythm rhythm is controlled by an electrical impulse from an
artificial cardiac pacemaker.
C88140 PACED RHYTHM Atrial and/or Ventricular Paced An electrocardiographic finding in which the cardiac Paced Rhythm
Rhythm;Paced Rhythm rhythm is controlled by an electrical impulse from an
C92234 PACED VENTRICULAR Paced Ventricular An electrocardiographic finding in which the Paced Ventricular Rhythm
RHYTHM Rhythm;Ventricular-paced ventricular rhythm is controlled by an electrical
complex(es) or rhythm impulse from an artificial cardiac pacemaker.
C62250 PAROXYSMAL AV BLOCK Paroxysmal AV block An electrocardiographic finding of the sudden onset Paroxysmal
of transient AV block, which is often associated with Atrioventricular Block by
preexisting conduction disorders. ECG Finding
C34902 PAROXYSMAL Paroxysmal Ventricular An episodic form of ventricular tachycardia, with Paroxysmal Ventricular
VENTRICULAR Tachycardia abrupt onset and termination. (NCI) Tachycardia by ECG
TACHYCARDIA Finding
C119250 PAUSE An electrocardiographic finding of an RR interval Pause by ECG Finding

which exceeds a predefined duration threshold,
regardless of the underlying rhythm.
C119251 PAUSE GREATER THAN An electrocardiographic finding of an RR interval Pause Greater Than Three
3.0 SECONDS with duration greater than 3.0 seconds, regardless Seconds by ECG Finding
of the underlying rhythm.
C114172 POOR QUALITY ECG An electrocardiographic recording that does not Poor Quality ECG
show proper quality for reasons that are not
otherwise described.
C71033 POOR R WAVE Poor R Wave Progression An electrocardiographic finding of a lack of Poor R Wave Progression
PROGRESSION progression of R wave height across precordial by ECG Finding
leads.
C35399 POSTERIOR WALL Posterior MI;Posterior Wall An electrocardiographic finding in leads V1 or V2 of Posterior Myocardial
MYOCARDIAL Myocardial Infarction an initial R wave duration greater than or equal to Infarction by ECG Finding
INFARCTION 40 ms, R wave greater than S wave, and upright T
the posterior wall of the left ventricle. Evidence of
also present.
C116135 PR SEGMENT PR Depression An electrocardiographic finding of PR segment PR Segment Depression

DEPRESSION depression below the iso-electric line in multiple by ECG Finding
precordial and/or limb leads.
C34940 PRE-EXCITATION Pre-excitation;Ventricular An electrocardiographic finding characterized by a Pre-Excitation Syndrome

preexcitation premature activation of the whole or some part of
the ventricle. The PR interval is usually shortened
and delta waves are frequently present.
C114153 PRECORDIAL ELECTRODE An electrocardiographic recording in which the Disconnected Precordial

V1 DISCONNECTED electrode for lead V1 is disconnected resulting in Electrode V1 by ECG
missing waveforms (flat line) for lead V1. Finding



page 440 of 1925

C71150 EGSTRESC
Code Value


C114160 PRECORDIAL An electrocardiographic recording in which one or Incorrectly Positioned

ELECTRODE(S) more precordial electrodes are placed incorrectly Precordial Electrodes by
POSITIONED with respect to the standard chest electrode ECG Finding
INCORRECTLY positions resulting in improper representation of the
affected leads.
C114152 PRECORDIAL Precordial Lead Reversal An electrocardiographic recording in which two or Interchanged Precordial
ELECTRODES more of the precordial electrodes are switched Electrodes by ECG Finding
INTERCHANGED resulting in improper representation of the affected
leads.
C62257 PREMATURE ATRIAL APC;Atrial premature An electrocardiographic finding of an ectopic impulse Atrial Premature Complex
COMPLEXES complex(es);PAC;Premature originating in the atria and not specifically in the by ECG Finding
atrial sinus node. The P wave morphology of these
complex;SVE;Supraventricular complexes is often different from a sinus P wave
Extra Beat;Supraventricular and the RR intervals preceding these complexes is
Premature Beat also shorter than those of the regular beats; there
C102603 PREMATURE ATRIAL Atrial premature complexes, An electrocardiographic finding of a premature atrial Blocked Atrial Premature
COMPLEXES BLOCKED nonconducted;Non-conducted complexes that are is not conducted to the Complex by ECG Finding
SVE;Premature Atrial Complex ventricles, and that are is not followed by a QRS
Blocked;Premature Atrial complex; there may be one or more occurrences
Complexes Non-conducted during an electrocardiographic recording.
C102672 PREMATURE ATRIAL Multifocal SVE;Multifocal An electrocardiographic finding of premature atrial Multifocal Atrial
COMPLEXES MULTIFOCAL Supraventricular Extra complexes which have 2 or more distinct Premature Complex by
Beats;Premature Atrial morphologies, suggesting origin at more than one ECG Finding
Complexes Multiform atrial site.
C102724 PREMATURE ATRIAL Premature Atrial Complexes An electrocardiographic finding of premature atrial Unifocal Atrial Premature
COMPLEXES UNIFOCAL Unifocal complexes which have a single distinct morphology, Complex by ECG Finding
suggesting origin at one atrial site.
C62256 PREMATURE PVC;Premature Ventricular An electrocardiographic finding of an ectopic impulse Ventricular Premature
VENTRICULAR COMPLEX Complexes;VE;VES;VPC;Ventri originating in the ventricles. The QRS morphology of Complex by ECG Finding
cular Extra Beat;Ventricular these complexes is different from those of
Premature Complexes supraventricular origin. The QRS duration is often
longer and the RR interval preceding the complexes
is usually shorter than that of supraventricular
beats; there may be one or more occurrences
during an electrocardiographic recording.
C107100 PREMATURE Interpolated VE;Interpolated An electrocardiographic finding of a premature Interpolated Premature

VENTRICULAR COMPLEX VES;Interpolated ventricular complex which occurs between two Ventricular Complex by
INTERPOLATED VPC;Interpolated Ventricular normal QRS complexes which have normal timing; ECG Finding
Extra Beat;Premature there may be one or more occurrences during an
Ventricular Complexes electrocardiographic recording.
Interpolated
C102673 PREMATURE Multifocal VES;Multifocal An electrocardiographic finding of premature Multifocal Ventricular

VENTRICULAR VPCS;Multifocal Ventricular ventricular complexes which have two or more Premature Complex by
COMPLEXES MULTIFOCAL Extra Beats;Premature distinct morphologies, suggesting origin at more ECG Finding
Ventricular Complexes than one ventricular site.
Multifocal
C102725 PREMATURE Premature Ventricular An electrocardiographic finding of premature Unifocal Ventricular

VENTRICULAR Complexes Unifocal;Unifocal ventricular complexes which have a single distinct Premature Complex by
COMPLEXES UNIFOCAL VES;Unifocal VPCS;Unifocal morphology, suggesting origin at one ventricular ECG Finding
Ventricular Extra Beats site.
C71034 PROLONGED QT Prolonged QT;Prolonged QT An electrocardiographic finding in which the QT Prolonged QT Interval by
interval interval not corrected for heart rate is prolonged. ECG Finding
Thresholds for different age, gender, and patient
populations exist.
C116137 PROLONGED ST An electrocardiographic finding of a prolonged ST Prolonged ST Segment by

SEGMENT segment, resulting in a long QT interval, without ECG Finding
lengthening of the T wave duration.
C71094 Q AXIS, LEFT AXIS Left-axis deviation;Q Axis, Left An electrocardiographic finding of a frontal plane Q Axis Left Axis Deviation
DEVIATION axis deviation;QRS axis, left QRS axis from -30 to -90 degrees.
axis deviation
page 441 of 1925

C71150 EGSTRESC
Code Value
C71095 Q AXIS, RIGHT AXIS Q Axis, Right axis An electrocardiographic finding of a frontal plane Q Axis Right Axis
DEVIATION deviation;QRS axis, right axis QRS axis from +90 to +180 degrees. Deviation
deviation;Right-axis deviation
C90440 QRS COMPLEX QRS Complex Abnormality An electrocardiographic finding of a non-specific QRS Complex
ABNORMALITY abnormality of the QRS complex, which is atypical in Abnormality by ECG
shape, duration, amplitude, axis or polarity. Finding
C83817 QTC PROLONGATION QTc Prolongation An electrocardiographic finding in which the QTc Corrected Prolonged QT
interval corrected for heart rate is prolonged. Interval by ECG Finding
populations exist.
C107098 QTCB PROLONGATION PROLONGED QTcB An electrocardiographic finding in which the QT QTcB Prolongation
formula is prolonged. Thresholds for different age,
gender, and patient populations exist.
C107099 QTCF PROLONGATION PROLONGED QTcF An electrocardiographic finding in which the QT QTcF Prolongation
C114161 QUALITY PROBLEM NOT Unknown Quality Problem An electrocardiographic artifact or recording error Quality Problem Not
OTHERWISE SPECIFIED with unknown origin or which is not described Otherwise Specified by
otherwise. ECG Finding
C61395 R ON T PHENOMENON R on T phenomenon An electrocardiographic finding in which the R wave R On T Phenomenon by

of a premature ventricular complex occurs on top of ECG Finding
the T wave of the preceding beat.
C90444 R WAVE NOTCHED R Wave Notched An electrocardiographic finding of an R wave variant R Wave Notched by ECG
in which there is a small deflection of the R wave, Finding
with changing polarity, within the QRS complex.
(NCI)
C102574 REPOLARIZATION Repolarization Abnormality An electrocardiographic finding of an abnormality of Ventricular Repolarization

ABNORMALITY T wave duration or morphology or of early Abnormality
repolarization.
C102706 REPOLARIZATION Repolarization Abnormality An electrocardiographic finding of ST depression and Repolarization

ABNORMALITY Secondary To Ventricular T wave inversion in the presence of increased QRS Abnormality Secondary
SECONDARY TO Hypertrophy;ST-T change due amplitude which are thought to be due to left To Ventricular
VENTRICULAR to ventricular hypertrophy ventricular hypertrophy. Hypertrophy
HYPERTROPHY
C71041 RIGHT ATRIAL P-pulmonale;Right Atrial An electrocardiographic finding suggesting P-pulmonale by ECG
ABNORMALITY Enlargement underlying hypertrophy or dilatation of the right Finding
diagnosis of right atrial abnormality may include a
peaked p wave greater than 2.5 millimeters in
amplitude in the inferior leads. (NCI)
C62270 RIGHT BUNDLE BRANCH Complete RBBB;Right bundle An electrocardiographic finding of a wide QRS Right Bundle Branch
BLOCK branch block;Right bundle- complex with evidence of delayed conduction to the Block by ECG Finding
branch block right ventricle, manifest by a widened initial portion
V6, I and aVL, and with QRS duration greater than
or equal to 120 ms. An RsR' complex is typically
present in leads V1 and V2.
C92235 RIGHT VENTRICULAR Right Ventricular Conduction An electrocardiographic finding in which there is Right Ventricular
CONDUCTION DELAY Delay;Right Ventricular Delay evidence that electrical transmission through the Conduction Delay by ECG
right ventricle is impaired with a maximal QRS Finding
duration of 110 ms and which does not meet the
criteria for Incomplete Right Bundle Branch Block.
C71077 RIGHT VENTRICULAR Right ventricular Hypertrophy An electrocardiographic finding suggestive of a Right Ventricular
HYPERTROPHY hypertrophied right ventricle, characterized by large Hypertrophy by ECG
R wave amplitudes in the right precordial leads and Finding
secondary findings of right atrial enlargement, right
axis deviation, and typical pattern of ST depression
and T wave inversion in the right precordial leads.
C92227 RSR PRIME RSR' An electrocardiographic finding in which there are RSR' by ECG Finding
two R waves, which are two deflections above the
baseline resulting from a single ventricular
depolarization. The first upward deflection in the
complex is the R wave. The S is the first downward
deflection. A second upward deflection is called the
R-prime wave.
C35519 SEPTAL MYOCARDIAL Septal myocardial infarction An electrocardiographic finding suggesting an Septal Myocardial
INFARCTION infarction in the anatomic location of the cardiac Infarction by ECG Finding
septum. (NCI)
page 442 of 1925

C71150 EGSTRESC
Code Value
C62246 SHORT PR INTERVAL Short PR interval An electrocardiographic finding of an abnormally Short PR Interval by ECG
short PR interval. Thresholds for different age, Finding
C102709 SHORT QTC INTERVAL Short QTc Interval An electrocardiographic finding of a QT interval Short QTc Interval
corrected for heart rate that is shorter than the
lower limit of normal. Thresholds for different age,
C112402 SHORT QTCB An electrocardiographic finding in which the QT QTcB Shortened

formula is shortened. Thresholds for different age,
C112403 SHORT QTCF An electrocardiographic finding in which the QT QTcF Shortened

C116136 SHORT ST SEGMENT An electrocardiographic finding of a short or absent Short ST Segment by

ST segment, resulting in a short QT interval, without ECG Finding
changes in T wave morphology.
C50553 SINOATRIAL EXIT BLOCK SA Block;Sinoatrial An electrocardiographic finding in which impaired Exit Block by ECG Finding
Block;Sinoatrial exit block conduction or automaticity within the sinus node
results in the failure of impulse transmission from
the sinoatrial node. This is manifest as dropped P
waves during sinus rhythm.
C62242 SINUS ARREST/PAUSE Sinus arrest/pause;Sinus An electrocardiographic finding in which a failure of Sinus Arrest by ECG
pause or arrest impulse formation or conduction in the sinus node Finding
produces prolongation of the P-P interval or dropped
P waves. The threshold for the prolongation of the
P-P interval is not well defined.
C62239 SINUS ARRHYTHMIA Respiratory Sinus An electrocardiographic finding in which the sinus Sinus Arrhythmia by ECG
Arrhythmia;Sinus arrhythmia rate fluctuates with the respiratory cycle. Finding
C111097 SINUS BRADYCARDIA Sinus bradycardia An electrocardiographic finding of abnormally slow Sinus Bradycardia by ECG
heart rate with its origin in the sinus node. Finding
populations exist.
C100076 SINUS RHYTHM Sinus Rhythm An electrocardiographic finding of an atrial rhythm Sinus Rhythm
considered normal for the population.
C111104 SINUS TACHYCARDIA Sinus tachycardia An electrocardiographic finding of abnormally rapid Sinus Tachycardia by ECG
populations exist.
C41330 ST DEPRESSION ST depression An electrocardiographic finding of ST segment ST Segment Depression

depression below the baseline, often described as by ECG Finding
up sloping, down sloping or horizontal. (NCI)
C50540 ST ELEVATION ST elevation An electrocardiographic finding of ST segment ST Segment Elevation by

elevation above the baseline. (NCI) ECG Finding
C71029 ST ELEVATION ST elevation pericarditis An electrocardiographic finding of ST elevation ST Elevation Pericarditis

PERICARDITIS which is concave upwards, and which is often by ECG Finding
accompanied by PR segment depression.
C119252 SUPRAVENTRICULAR An electrocardiographic finding in which two Supraventricular Couplet

COUPLET premature atrial complexes occur sequentially. by ECG Finding
C135395 SUPRAVENTRICULAR Supraventricular Escape An electrocardiographic finding of a compensatory Supraventricular Escape

ESCAPE BEAT Complex;Supraventricular supraventricular complex that occurs following a Beat by ECG Finding
Escape Complexes prolonged RR interval.
C142246 SUPRAVENTRICULAR Supraventricular Premature An electrocardiographic finding of an ectopic impulse Supraventricular

PREMATURE COMPLEX, Complexes, Origin Unknown originating from the atria or AV junction for which Premature Complex With
ORIGIN UNKNOWN the site of origin cannot be determined from the Unknown Origin by ECG
surface electrocardiographic recording; there may Finding
be one or more occurrences during an
C111100 SUPRAVENTRICULAR Supraventricular tachycardia An electrocardiographic finding of a tachycardia Supraventricular

TACHYCARDIA which does not originate in the ventricles or His Tachycardia by ECG
Purkinje system. There is an abnormally high heart Finding
rate and QRS complexes are typically narrow, but
aberration or preexcitation may be present.
page 443 of 1925

C71150 EGSTRESC
Code Value
C114173 SUSPECT LIMB An electrocardiographic recording in which an Suspicion of Limb

ELECTRODES REVERSED, interchange of one or more limb lead electrodes is Electrodes Reversal But
INTERPRETATION suspected, but for which an interpretation is Interpretation Assumes
ASSUMES NO REVERSAL performed as though the lead placement is correct. No Reversal by ECG
Finding

INTERPRETATION suspected, and for which an interpretation is Interpretation Assumes
ASSUMES REVERSAL performed as though the leads have in fact been Reversal by ECG Finding
interchanged.
C71052 SUSTAINED Sustained ventricular An electrocardiographic finding of ventricular Sustained Ventricular

VENTRICULAR tachycardia tachycardia greater than 30 seconds in duration. Tachycardia by ECG
TACHYCARDIA (NCI) Finding
C102718 T WAVE ALTERNANS T Wave Alternans An electrocardiographic finding in which there are T Wave Alternans by ECG
variations in the shape, amplitude, or direction of Finding
the T wave from one beat to the next.
C71085 T WAVE INVERSION T Wave Inversion An electrocardiographic finding of an inversion of T Wave Inversion by ECG
the T wave from the expected axis. (NCI) Finding
C71086 T WAVE PEAKED T wave peaked An electrocardiographic finding in which the T wave T Wave Peaked by ECG
appears increased in amplitude and cresting at a Finding
point. (NCI)
C71087 T WAVES BIPHASIC T waves biphasic An electrocardiographic finding of a T wave with T Waves Biphasic by ECG
both positive and negative components. Finding
C71088 T WAVES FLAT T waves flat An electrocardiographic finding in which the T wave T Waves Flat by ECG
appears decreased in amplitude. (NCI) Finding
C111121 TACHYCARDIA Tachycardia An electrocardiographic finding of abnormally rapid Tachycardia by ECG

C50779 TORSADES DE POINTES Torsades de An electrocardiographic finding of an atypical rapid Torsades De Pointes by
pointes;Ventricular polymorphic ventricular tachycardia with a ECG Finding
tachycardia, torsades de characteristic rotation of the QRS complex around
pointes the isoelectric baseline, occurring in the setting of a
prolonged QT interval. In addition, the QRS complex
displays a periodic waxing and waning of amplitude
on the electrogram.
C106579 U WAVE ABNORMALITY Abnormal U Wave An electrocardiographic finding of U waves which U Wave Abnormality by
have increased amplitude, are inverted, or merged ECG Finding
with the preceding T wave.
C114170 UNABLE TO DIGITIZE A statement indicating the inability to digitize a Inability to Digitize ECG
ECG LEADS paper ECG. Leads
C116131 UNDETERMINED RHYTHM An electrocardiographic finding of a cardiac rhythm Undetermined Rhythm by

whose mechanism cannot be determined from the ECG Finding
ECG.
C120607 UNDETERMINED An electrocardiographic finding of a rhythm which Undetermined

SUPRAVENTRICULAR does not originate in the ventricles or His Purkinje Supraventricular Rhythm
RHYTHM system, but whose specific electrophysiologic by ECG Finding
mechanism cannot be determined from the ECG.
The QRS complexes are typically narrow, but
C71054 VENTRICULAR BIGEMINY Bigeminy An electrocardiographic finding of a normal QRS Ventricular Bigeminy by
complex followed by a premature ventricular ECG Finding
complex for 3 or more consecutive cycles; a
regularly irregular rhythm of normal and abnormal
QRS complexes in a 1-1 ratio.
C62259 VENTRICULAR COUPLET Ventricular An electrocardiographic finding in which two Ventricular Couplet by
Couplets;Ventricular Pair premature ventricular complexes occur sequentially; ECG Finding
C90483 VENTRICULAR ESCAPE Ventricular Escape An electrocardiographic finding of a compensatory Ventricular Escape Beat
BEAT Beats;Ventricular Escape ventricular complex that occurs following a by ECG Finding
Complex;Ventricular Escape prolonged RR interval; there may be one or more
Complexes occurrences during an electrocardiographic
recording.
C111102 VENTRICULAR Ventricular fibrillation An electrocardiographic finding of a rapid grossly Ventricular Fibrillation by
FIBRILLATION irregular ventricular rhythm with marked variability ECG Finding
in QRS cycle length, morphology, and amplitude.
The rate is typically greater than 300 bpm.
page 444 of 1925

C71150 EGSTRESC
Code Value
C111115 VENTRICULAR FLUTTER Ventricular flutter A ventricular tachyarrhythmia characterized by a Ventricular Flutter by ECG
high ventricular rate (180 to 250 beats per minute) Finding
with a regular rhythm. The electrocardiogram shows
large oscillating sine wave-like complexes occurring
as a result of QRS complexes and T waves being
merged. The P wave is not visible. (NCI)
C102728 VENTRICULAR Parasystole;Ventricular An electrocardiographic finding of normal sinus Ventricular Parasystole by

PARASYSTOLE Parasystole rhythm coexisting with a regular ectopic ventricular ECG Finding
rhythm.
C111103 VENTRICULAR Ventricular tachycardia An electrocardiographic finding of three or more Ventricular Tachycardia
TACHYCARDIA consecutive complexes of ventricular organ with a by ECG Finding
rate greater than a certain threshold (100 or 120
beats per minute are commonly used). The QRS
morphology.
C62234 VENTRICULAR Ventricular tachycardia, An electrocardiographic finding of a ventricular Monomorphic Ventricular

TACHYCARDIA, monomorphic tachycardia in which the QRS complexes have a Tachycardia by ECG
MONOMORPHIC uniform morphology. Finding
C62236 VENTRICULAR Ventricular tachycardia, An electrocardiographic finding of a ventricular Polymorphic Ventricular

TACHYCARDIA, polymorphic;Ventricular tachycardia in which the QRS complexes have a Tachycardia by ECG
POLYMORPHIC tachycardia, polymorphous variable morphology and often rate. Finding
C71055 VENTRICULAR Trigeminy An electrocardiographic finding of two normal QRS Ventricular Trigeminy by
TRIGEMINY complexes followed by a premature ventricular ECG Finding
C130067 VOLTAGE CRITERIA An electrocardiographic finding of large QRS Voltage Criteria

SUGGESTING LEFT amplitudes which may indicate left ventricular Suggesting Left
VENTRICULAR hypertrophy, but in the absence of any of the Ventricular Hypertrophy,
HYPERTROPHY, WITHOUT secondary findings which are typical of this Without Secondary ECG
SECONDARY ECG diagnosis (left atrial enlargement, left axis Findings
FINDINGS deviation, or typical pattern of ST depression and T
wave inversion).
C62240 WANDERING ATRIAL Wandering atrial pacemaker An electrocardiographic finding of a supraventricular Wandering Atrial
PACEMAKER arrhythmia characterized by 3 or more distinct P Pacemaker by ECG
rhythm. The ventricular rate is typically below 100
beats per minute.
C71090 WIDE QRS TACHYCARDIA Wide QRS tachycardia;Wide- An electrocardiographic finding of three or more Wide QRS Tachycardia by
QRS tachycardia consecutive wide QRS complexes of uncertain origin ECG Finding
with a rate greater than a certain threshold (100 or
120 beats per minute are commonly used).
C35132 WOLFF-PARKINSON- WPW;Wolff-Parkinson-White An electrocardiographic finding of ventricular pre- Wolff-Parkinson-White

WHITE SYNDROME syndrome excitation. The syndrome is characterized by a short Syndrome
PR interval and a long QRS interval with a delta
wave.
page 445 of 1925

EGTEST (ECG Test Name)
C71152 EGTEST
Code Value
C116140 Acute Myocardial Acute Myocardial An electrocardiographic finding assessment of new or Acute Myocardial
Ischemia ECG Change Ischemia ECG Change presumed new significant ST-segment-T wave (ST-T) Ischemia by ECG
changes or new left bundle branch block consistent with Assessment
acute myocardial ischemia. (Thygesen K, Alpert JS, Jaffe
AS, Simoons ML, et al.; Joint ESC/ACCF/AHA/WHF Task
Force for Universal Definition of Myocardial Infarction.
Third universal definition of myocardial infarction. J Am
Coll Cardiol. 2012 Oct 16;60(16):1581-98).
C111131 Atrioventricular Atrioventricular An electrocardiographic assessment of cardiac Atrioventricular

Conduction Conduction atrioventricular conduction. Conduction ECG
Assessment
C111132 Axis and Voltage Axis and Voltage An electrocardiographic assessment of mean cardiac Axis and Voltage ECG
electrical vector and the ECG voltage. Assessment
C111155 Chamber Hypertrophy or Chamber Hypertrophy or An electrocardiographic assessment of chamber Chamber Hypertrophy or
Enlargement Enlargement hypertrophy or enlargement. Enlargement ECG
Assessment
C117761 Comparison to a Prior Comparison to a Prior A comparative interpretation of an ECG relative to a Comparison to a Prior
ECG ECG previous (comparator) ECG. The definition of the ECG
comparator ECG may be specified elsewhere. Common
comparator result values include improved, no change,
deteriorated.
C119253 ECG Maximum Atrial Rate ECG Maximum Atrial Rate An electrocardiographic measurement of the maximum Maximum Atrial Rate by
rate of atrial depolarizations (P waves) recorded during Electrocardiogram
an interval of time, usually expressed in beats per
minute.
C119257 ECG Maximum Heart Rate ECG Maximum Heart Rate An electrocardiographic measurement of the maximum Maximum Heart Rate by
rate of depolarization of a specific region of the heart Electrocardiogram
during an interval of time, usually expressed in beats per
minute. Unless otherwise specified, this is usually the
maximum ventricular rate.
C119260 ECG Maximum Ventricular ECG Maximum Ventricular An electrocardiographic measurement of the maximum Maximum Ventricular
Rate Rate rate of ventricular depolarizations (QRS complexes) Rate by
recorded during an interval of time, usually expressed in Electrocardiogram
beats per minute.
C119256 ECG Mean Atrial Rate ECG Mean Atrial Rate An electrocardiographic measurement of the average rate Mean Atrial Rate by
of atrial depolarizations (P waves) recorded during an Electrocardiogram
interval of time, usually expressed in beats per minute.
C119259 ECG Mean Heart Rate ECG Mean Heart Rate An electrocardiographic measurement of the average rate Mean Heart Rate by
of depolarization of a specific region of the heart during Electrocardiogram
mean ventricular rate.
C119263 ECG Mean Ventricular ECG Mean Ventricular An electrocardiographic measurement of the average rate Mean Ventricular Rate by
Rate Rate of ventricular depolarizations (QRS complexes) recorded Electrocardiogram
minute.
C119254 ECG Median Atrial Rate ECG Median Atrial Rate An electrocardiographic measurement of the median rate Median Atrial Rate by
C123447 ECG Median Heart Rate ECG Median Heart Rate An electrocardiographic measurement of the median rate ECG Median Heart Rate
of depolarization of a specific region of the heart during
median ventricular rate.
C119261 ECG Median Ventricular ECG Median Ventricular An electrocardiographic measurement of the median rate Median Ventricular Rate
Rate Rate of ventricular depolarizations (QRS complexes) recorded by Electrocardiogram
minute.
C119255 ECG Minimum Atrial Rate ECG Minimum Atrial Rate An electrocardiographic measurement of the minimum Minimum Atrial Rate by
minute.
page 446 of 1925

C71152 EGTEST
Code Value
C119258 ECG Minimum Heart Rate ECG Minimum Heart Rate An electrocardiographic measurement of the minimum Minimum Heart Rate by
minimum ventricular rate.
C119262 ECG Minimum Ventricular ECG Minimum Ventricular An electrocardiographic measurement of the minimum Minimum Ventricular Rate
Rate Rate rate of ventricular depolarizations (QRS complexes) by Electrocardiogram
recorded during an interval of time, usually expressed in
beats per minute.

formal language.
C111238 Intraventricular- Intraventricular- An electrocardiographic assessment of intraventricular Intraventricular and

Intraatrial Conduction Intraatrial Conduction and intra-atrial conduction. Intraatrial Conduction
ECG Assessment
C117767 J-Tpeak Interval, J-Tpeak Interval, An aggregate J-Tpeak value based on the measurement Aggregate J-T Peak
Aggregate Aggregate of J-Tpeak intervals from multiple beats within a single Interval
ECG. The method of aggregation, which can vary, is
typically a measure of central tendency such as the
mean.
C117768 J-Tpeak Interval, Single J-Tpeak Interval, Single An electrocardiographic interval measured from the J Single Beat J-T Peak
Beat Beat point to the peak of the T wave of a single beat utilizing Interval
one or more leads.
C117762 JT Interval, Aggregate JT Interval, Aggregate An aggregate JT value based on the measurement of JT Aggregate JT Interval
intervals from multiple beats within a single ECG. The
method of aggregation, which can vary, is typically a
measure of central tendency such as the mean.
C117769 JT Interval, Single Beat JT Interval, Single Beat An electrocardiographic interval measured from the J Single Beat JT Interval
point to the offset of the T wave of a single beat utilizing
one or more leads.
C117763 JTcB Interval, Aggregate JTcB Interval, Aggregate A JT aggregate interval that is corrected for heart rate Aggregate JTCB Interval
using Bazett's formula, based on the measurement of QT
C117764 JTcB Interval, Single Beat JTcB Interval, Single Beat A JT single beat interval that is corrected for heart rate Single Beat JTCB Interval
using Bazett's formula, based on a QT interval measured
on a single beat utilizing one or more ECG leads.
C117765 JTcF Interval, Aggregate JTcF Interval, Aggregate A JT aggregate interval that is corrected for heart rate Aggregate JTCF Interval
using Fridericia's formula, based on the measurement of
QT intervals from multiple beats within a single ECG. The
C117766 JTcF Interval, Single Beat JTcF Interval, Single Beat A JT single beat interval that is corrected for heart rate Single Beat JTCF Interval
using Fridericia's formula, based on a QT interval
measured on a single beat utilizing one or more ECG
leads.
C111280 Myocardial Infarction Myocardial Infarction An electrocardiographic assessment of findings suggestive Myocardial Infarction ECG
of myocardial infarction. Assessment
C117770 New Q Wave New Q Wave An electrocardiographic finding assessment of new or New Q Wave
presumed new pathologic Q waves suggestive of
myocardial infarction. (Thygesen K, Alpert JS, Jaffe AS,
Simoons ML, et al.; Joint ESC/ACCF/AHA/WHF Task Force
for Universal Definition of Myocardial Infarction. Third
universal definition of myocardial infarction. J Am Coll
Cardiol. 2012 Oct 16;60(16):1581-98).
C117777 P Wave Amplitude, P Wave Amplitude, An aggregate P wave amplitude value based on the Aggregate P Wave
Aggregate Aggregate measurement of P wave amplitudes from multiple beats Amplitude
within a single ECG. The method of aggregation, which
can vary, is typically a measure of central tendency such
as the mean.
page 447 of 1925

C71152 EGTEST
Code Value
C117778 P Wave Amplitude, Single P Wave Amplitude, Single An electrocardiographic measurement of the mean Single Beat P Wave
Beat Beat amplitude (usually measured in mV) of the P wave Amplitude
measured from the isoelectric baseline to the peak of the
P wave of a single beat utilizing one or more leads. Based
on the recording gain, this measurement may also be
reported in mm.
C118164 P Wave Axis P Wave Axis A numerical representation of the electrocardiographic P Wave Axis
vector assessed at maximum deviation of the P wave
from the isoelectric baseline, usually reported for the
frontal plane.
C117775 P Wave Duration, P Wave Duration, An aggregate P wave duration value based on the Aggregate P Wave
Aggregate Aggregate measurement of P wave duration intervals from multiple Duration
beats within a single ECG. The method of aggregation,
which can vary, is typically a measure of central tendency
such as the mean.
C117776 P Wave Duration, Single P Wave Duration, Single An electrocardiographic interval measured from the onset Single Beat P Wave
Beat Beat of the P wave to the offset of the P wave of a single beat Duration
utilizing one or more leads.
C111285 Pacemaker Pacemaker An electrocardiographic assessment of presence of Pacemaker ECG

artificial electronic pacing. Assessment
C117771 PP Interval, Aggregate PP Interval, Aggregate An aggregate PP value based on the measurement of PP Aggregate PP Interval
C117772 PP Interval, Single PP Interval, Single An electrocardiographic measurement of the interval Single Measurement PP
Measurement Measurement between the onsets of two consecutive P waves. Interval
C117773 PR Interval, Aggregate PR Interval, Aggregate An aggregate PR value based on the measurement of PR Aggregate PR Interval
C117774 PR Interval, Single Beat PR Interval, Single Beat An electrocardiographic interval measured from the onset Single Beat PR Interval
of the P wave to the onset of the QRS complex of a single
beat utilizing one or more leads.
C117789 Q Wave Amplitude, Q Wave Amplitude, An aggregate Q wave amplitude value based on the Aggregate Q Wave
Aggregate Aggregate measurement of Q wave amplitudes from multiple beats Amplitude
as the mean.
C117790 Q Wave Amplitude, Single Q Wave Amplitude, Single An electrocardiographic measurement of the mean Single Beat Q Wave
Beat Beat amplitude (usually measured in mV) of the Q wave Amplitude
Q wave of a single beat utilizing one or more leads. Based
reported in mm.
C118165 QRS Axis QRS Axis A numerical representation of the electrocardiographic QRS Axis
vector assessed at maximum deviation of the QRS
complex from the isoelectric baseline, usually reported for
the frontal plane.
C117779 QRS Duration, Aggregate QRS Duration, Aggregate An aggregate QRS value based on the measurement of Aggregate QRS Duration
QRS intervals from multiple beats within a single ECG.
The method of aggregation, which can vary, is typically a
C117780 QRS Duration, Single QRS Duration, Single An electrocardiographic interval measured from the onset Single Beat QRS Duration
Beat Beat of the QRS complex to the offset of the QRS complex of a
single beat utilizing one or more leads.
C117781 QRS Duration, Ventr. QRS Duration, Ventr. An aggregate paced QRS duration value based on the Paced Ventricular
Paced, Aggregate Paced, Aggregate measurement of paced QRS duration intervals from Aggregate QRS Duration
multiple beats within a single ECG. The method of
aggregation, which can vary, is typically a measure of
central tendency such as the mean.
C117782 QRS Duration, Ventr. QRS Duration, Ventr. An electrocardiographic interval measured from the onset Paced Ventricular Single
Paced, Single Beat Paced, Single Beat of the paced QRS complex to the offset of the QRS Beat QRS Duration
complex of a single beat utilizing one or more leads.
C117783 QT Interval, Aggregate QT Interval, Aggregate An aggregate QT value based on the measurement of QT Aggregate QT Interval
page 448 of 1925

C71152 EGTEST
Code Value
C117788 QT Interval, Single Beat QT Interval, Single Beat An electrocardiographic interval measured from the onset Single Beat QT Interval
of the QRS complex to the offset of the T wave of a single
C100391 QTc Correction Method QTc Correction Method A QT interval that is corrected for heart rate by Corrected QT Interval
Unspecified Unspecified unspecified correction method.
C124332 QTca Interval, Aggregate QTca Interval, Aggregate A QT Aggregate interval that is corrected for heart rate Aggregate QTca Interval
using individual probabilistic QT/RR slopes for each
subject, based on the measurement of QT intervals from
multiple beats within a single ECG or period of a
continuous ECG. The method of aggregation, which can
vary, is typically a measure of central tendency such as
the mean.
C124333 QTca Interval, Single QTca Interval, Single A QT interval that is corrected for heart rate using Single Beat QTca Interval
Beat Beat individual probabilistic QT/RR slopes for each subject,
based on a QT interval measured on a single beat utilizing
one or more ECG leads.
C117784 QTcB Interval, Aggregate QTcB Interval, Aggregate A QT aggregate interval that is corrected for heart rate Aggregate QTCB Interval
C117785 QTcB Interval, Single QTcB Interval, Single A QT single beat interval that is corrected for heart rate Single Beat QTCB Interval
Beat Beat using Bazett's formula, based on a QT interval measured
C117786 QTcF Interval, Aggregate QTcF Interval, Aggregate A QT aggregate interval that is corrected for heart rate Aggregate QTCF Interval
C117787 QTcF Interval, Single QTcF Interval, Single A QT single beat interval that is corrected for heart rate Single Beat QTCF Interval
Beat Beat using Fridericia's formula, based on a QT interval
leads.
C123448 QTcL Interval, Aggregate QTcL Interval, Aggregate A QT aggregate interval corrected for heart rate using a Aggregate QTcL Interval
linear correction formula.
C123449 QTcL Interval, Single Beat QTcL Interval, Single Beat A QT single beat interval corrected for heart rate using a Single Beat QTcL Interval
C123450 QTcV Interval, Aggregate QTcV Interval, Aggregate A QT aggregate interval corrected for heart rate using the Aggregate QTcV Interval
Van der Water's correction formula.
C123451 QTcV Interval, Single QTcV Interval, Single A QT single beat interval corrected for heart rate using Single Beat QTcV Interval
Beat Beat the Van der Water's correction formula.
C117795 R Wave Amplitude, R Wave Amplitude, An aggregate R wave amplitude value based on the R Wave Amplitude
Aggregate Aggregate measurement of R wave amplitudes from multiple beats Aggregate
as the mean.
C117796 R Wave Amplitude, Single R Wave Amplitude, Single An electrocardiographic measurement of the mean R Wave Amplitude Single
Beat Beat amplitude (usually measured in mV) of the R wave Beat
R wave of a single beat utilizing one or more leads. Based
reported in mm.
C111307 Rhythm Not Otherwise Rhythm Not Otherwise An electrocardiographic assessment of cardiac rhythm not Rhythm Not Otherwise
Specified Specified otherwise specified. Specified ECG
Assessment
C117791 RR Interval, Aggregate RR Interval, Aggregate An aggregate RR value based on the measurement of RR Aggregate RR Interval
C117792 RR Interval, Single RR Interval, Single An electrocardiographic measurement of the interval RR Interval Single
Measurement Measurement between two consecutive R waves. If R waves are not Measurement
present, this measurement may utilize the interval
between the most easily identified components of the
QRS complex within two consecutive beats.
page 449 of 1925

C71152 EGTEST
Code Value
C117793 RS Wave Amplitude, RS Wave Amplitude, An aggregate RS wave amplitude value based on RS Wave Amplitude
Aggregate Aggregate measurements from multiple beats from a single ECG. Aggregate
C117794 RS Wave Amplitude, RS Wave Amplitude, An electrocardiographic measurement of the sum of the RS Wave Amplitude
Single Beat Single Beat amplitudes of the R and S waves, obtained from a single Single Beat
beat in one particular lead or set of leads.
C117805 S Wave Amplitude, S Wave Amplitude, An aggregate S wave amplitude value based on the S Wave Amplitude
Aggregate Aggregate measurement of S wave amplitudes from multiple beats Aggregate
as the mean.
C117806 S Wave Amplitude, Single S Wave Amplitude, Single An electrocardiographic measurement of the mean S Wave Amplitude Single
Beat Beat amplitude (usually measured in mV) of the S wave Beat
S wave of a single beat utilizing one or more leads. Based
reported in mm.
C120608 Single RR Heart Rate Single RR Heart Rate An electrocardiographic measurement of a heart rate Single Beat RR
derived from a single RR interval (interval between two Extrapolated Heart Rate
consecutive QRS complexes). by ECG Assessment
C111312 Sinus Node Rhythms and Sinus Node Rhythms and An electrocardiographic assessment of sinus node Sinus Node Rhythm and
Arrhythmias Arrhythmias rhythms and arrhythmias. Arrhythmia ECG
Assessment
C117797 ST Segment Depression, ST Segment Depression, An aggregate ST segment depression value based on the ST Segment Depression
Aggregate Aggregate measurement of ST segment depression from multiple Aggregate
such as the mean.
C117798 ST Segment Depression, ST Segment Depression, An electrocardiographic measurement of the mean ST Segment Depression
Single Beat Single Beat amplitude (usually measured in mV) of the ST segment Single Beat
depression below the isoelectric baseline measured from
the baseline to the ST segment of a single beat utilizing
one or more leads. Based on the recording gain, this
measurement may also be reported in mm.
C117799 ST Segment Deviation, ST Segment Deviation, An aggregate ST segment deviation value based on the ST Segment Deviation
Aggregate Aggregate measurement of ST segment deviation from multiple Aggregate
such as the mean.
C117800 ST Segment Deviation, ST Segment Deviation, An electrocardiographic measurement of the mean ST Segment Deviation
deviation above or below the isoelectric baseline
measured from the baseline to the ST segment of a single
beat utilizing one or more leads. Based on the recording
gain, this measurement may also be reported in mm.
C117803 ST Segment Duration, ST Segment Duration, An aggregate ST segment duration value based on the ST Segment Duration
Aggregate Aggregate measurement of ST segment duration intervals from Aggregate
C117804 ST Segment Duration, ST Segment Duration, An electrocardiographic interval measured from the J ST Segment Duration
Single Beat Single Beat point to the onset of the T wave of a single beat utilizing Single Beat
one or more leads.
C117801 ST Segment Elevation, ST Segment Elevation, An aggregate ST segment elevation value based on the ST Segment Elevation
Aggregate Aggregate measurement of ST segment elevation from multiple Aggregate
such as the mean.
C117802 ST Segment Elevation, ST Segment Elevation, An electrocardiographic measurement of the mean ST Segment Elevation
elevation above the isoelectric baseline measured from
C111363 ST Segment, T wave, and ST Segment, T wave, and An electrocardiographic assessment of the characteristics ST Segment, T wave, and
U wave U wave of the ST segment, T wave, and U wave. U wave ECG Assessment
page 450 of 1925

C71152 EGTEST
Code Value
C62117 Summary (Max) JT Summary (Max) JT The maximum duration (time) of the JT interval, obtained Maximum JT Duration
Interval Interval from a set of measurements of the JT interval. The JT
interval is defined as the time from the J point (end of
ventricular depolarization, the point at which the QRS
meets the ST segment) to the end of the T wave
(representing the end of ventricular repolarization). (NCI)
C62131 Summary (Max) PR Summary (Max) PR The maximum duration (time) of the PR interval, Maximum PR Duration
Duration Duration obtained from a set of measurements of the PR interval.
The PR interval is defined as the time from the beginning
of the P wave (representing the onset of atrial
depolarization) to the beginning of the R wave
(representing the onset of ventricular depolarization). In
some cases, a Q wave will precede the R wave, in which
case the PR interval is measured from the beginning of
the P wave to the beginning of the Q wave. (NCI)
C62135 Summary (Max) QT Summary (Max) QT The maximum duration (time) of the QT interval, Maximum QT Duration
Duration Duration obtained from a set of measurements of the QT interval.
The QT interval is defined as the time from the beginning
of the QRS complex to the end of the T wave,
representing the time it takes for the ventricles to
depolarize and subsequently repolarize. In some cases,
the Q wave will be absent, in which case the QT interval
is measured from the beginning of the R wave to the end
of the T wave. (NCI)
C62094 Summary (Max) RR Summary (Max) RR The maximum duration (time) between successive peaks Maximum RR Duration
Duration Duration of R waves in a particular set of RR intervals. (NCI)
C62163 Summary (Max) ST Summary (Max) ST The maximum depression (negative deflection from Maximum ST Segment
Depression Depression baseline, usually measured in mm) of the ST segment, Depression by ECG
obtained from a set of measurements of the depression of Finding
the ST segment. (NCI)
C62157 Summary (Max) ST Summary (Max) ST The maximum deviation (distance from baseline, positive Maximum ST Deviation
Deviation Deviation or negative, usually measured in mm) of the ST segment,
obtained from a set of measurements of the deviation of
C62160 Summary (Max) ST Summary (Max) ST The maximum elevation (positive deflection from Maximum ST Segment
Elevation Elevation baseline, usually measured in mm) of the ST segment, Elevation
obtained from a set of measurements of the elevation of
C62116 Summary (Min) JT Summary (Min) JT The minimum duration (time) of the JT interval, obtained Minimum JT Duration
Interval Interval from a set of measurements of the JT interval. The JT
C62125 Summary (Min) PR Summary (Min) PR The minimum duration (time) of the PR interval, obtained Minimum PR Duration
Duration Duration from a set of measurements of the PR interval. The PR
interval is defined as the time from the beginning of the P
wave (representing the onset of atrial depolarization) to
the beginning of the R wave (representing the onset of
ventricular depolarization). In some cases, a Q wave will
precede the R wave, in which case the PR interval is
measured from the beginning of the P wave to the
beginning of the Q wave. (NCI)
C62133 Summary (Min) QT Summary (Min) QT The minimum duration (time) of the QT interval, obtained Minimum QT Duration
Duration Duration from a set of measurements of the QT interval. The QT
interval is defined as the time from the beginning of the
QRS complex to the end of the T wave, representing the
time it takes for the ventricles to depolarize and
subsequently repolarize. In some cases, the Q wave will
be absent, in which case the QT interval is measured
from the beginning of the R wave to the end of the T
wave. (NCI)
C62093 Summary (Min) RR Summary (Min) RR The minimum duration (time) between successive peaks Minimum RR Duration
Duration Duration of R waves in a particular set of RR intervals. (NCI)
C62162 Summary (Min) ST Summary (Min) ST The minimum depression (negative deflection from Minimum ST Segment
Depression Depression baseline, usually measured in mm) of the ST segment, Depression by ECG
C62156 Summary (Min) ST Summary (Min) ST The minimum deviation (distance from baseline, positive Minimum ST Deviation
Deviation Deviation or negative, usually measured in mm) of the ST segment,
page 451 of 1925

C71152 EGTEST
Code Value
C62159 Summary (Min) ST Summary (Min) ST The minimum elevation (positive deflection from baseline, Minimum ST Segment
Elevation Elevation usually measured in mm) of the ST segment, obtained Elevation
from a set of measurements of the elevation of the ST
segment. (NCI)
C111320 Supraventricular Supraventricular An electrocardiographic assessment of supraventricular Supraventricular

Arrhythmias Arrhythmias arrhythmias excluding tachycardias. Arrhythmia ECG
Assessment

Tachyarrhythmias Tachyarrhythmias tachyarrhythmias. Tachyarrhythmia ECG
Assessment
C117814 T Wave Amplitude, T Wave Amplitude, An aggregate T wave amplitude value based on the T Wave Amplitude
Aggregate Aggregate measurement of T wave amplitudes from multiple beats Aggregate
as the mean.
C117815 T Wave Amplitude, Single T Wave Amplitude, Single An electrocardiographic measurement of the mean T Wave Amplitude Single
Beat Beat amplitude (usually measured in mV) of the T wave Beat
T wave of a single beat utilizing one or more leads. Based
reported in mm.
C117810 T Wave Area, Aggregate T Wave Area, Aggregate An aggregate T wave area value based on the T Wave Area Aggregate
measurement of T wave areas from multiple beats within
a single ECG. The method of aggregation, which can vary,
is typically a measure of central tendency such as the
mean.
C117811 T Wave Area, Single Beat T Wave Area, Single Beat An electrocardiographic measurement of the area of the T T Wave Area Single Beat
wave of a single beat utilizing one or more leads.
C118166 T Wave Axis T Wave Axis A numerical representation of the electrocardiographic T Wave Axis
vector assessed at maximum deviation of the T wave
frontal plane.
C117812 T Wave Duration, T Wave Duration, An aggregate T wave duration value based on the T Wave Duration
Aggregate Aggregate measurement of T wave duration intervals from multiple Aggregate
such as the mean.
C117813 T Wave Duration, Single T Wave Duration, Single An electrocardiographic interval measured from the onset T Wave Duration Single
Beat Beat of the T wave to the offset of the T wave of a single beat Beat
C117807 Technical Quality Technical Quality A statement about an electrocardiographic recording ECG Technical Quality
describing technical issues or interference during the
recording, processing, or transmission of the data. This
does not represent an electrocardiographic diagnosis.
C117808 Tpeak-Tend Interval, Tpeak-Tend Interval, An aggregate Tpeak-Tend value based on the T Peak-T End Interval
Aggregate Aggregate measurement of Tpeak-Tend from multiple beats within a Aggregate
single ECG. The method of aggregation, which can vary,
mean.
C117809 Tpeak-Tend Interval, Tpeak-Tend Interval, An electrocardiographic interval measured from the peak T Peak-T End Interval
Single Beat Single Beat of the T wave to the offset of the T wave of a single beat Single Beat
C111330 Ventricular Arrhythmias Ventricular Arrhythmias An electrocardiographic assessment of ventricular Ventricular Arrhythmia
arrhythmias excluding tachycardias. ECG Assessment
C111331 Ventricular Ventricular An electrocardiographic assessment of ventricular Ventricular

Assessment
page 452 of 1925

EGTESTCD (ECG Test Code)
C71153 EGTESTCD
Code Value
C116140 AMIEGCHG Acute Myocardial An electrocardiographic finding assessment of new or Acute Myocardial
Ischemia ECG Change presumed new significant ST-segment-T wave (ST-T) Ischemia by ECG
changes or new left bundle branch block consistent with Assessment
acute myocardial ischemia. (Thygesen K, Alpert JS, Jaffe
AS, Simoons ML, et al.; Joint ESC/ACCF/AHA/WHF Task
Force for Universal Definition of Myocardial Infarction.
Third universal definition of myocardial infarction. J Am
Coll Cardiol. 2012 Oct 16;60(16):1581-98).
C111131 AVCOND Atrioventricular An electrocardiographic assessment of cardiac Atrioventricular

Conduction atrioventricular conduction. Conduction ECG
Assessment
C111132 AXISVOLT Axis and Voltage An electrocardiographic assessment of mean cardiac Axis and Voltage ECG
C111155 CHYPTENL Chamber Hypertrophy or An electrocardiographic assessment of chamber Chamber Hypertrophy or

Enlargement hypertrophy or enlargement. Enlargement ECG
Assessment
C119253 EGARMAX ECG Maximum Atrial Rate An electrocardiographic measurement of the maximum Maximum Atrial Rate by
minute.
C119254 EGARMED ECG Median Atrial Rate An electrocardiographic measurement of the median rate Median Atrial Rate by
C119255 EGARMIN ECG Minimum Atrial Rate An electrocardiographic measurement of the minimum Minimum Atrial Rate by
minute.
C119256 EGARMN ECG Mean Atrial Rate An electrocardiographic measurement of the average rate Mean Atrial Rate by
C117761 EGCOMP Comparison to a Prior A comparative interpretation of an ECG relative to a Comparison to a Prior
ECG previous (comparator) ECG. The definition of the ECG
deteriorated.
C119257 EGHRMAX ECG Maximum Heart Rate An electrocardiographic measurement of the maximum Maximum Heart Rate by
maximum ventricular rate.
C123447 EGHRMED ECG Median Heart Rate An electrocardiographic measurement of the median rate ECG Median Heart Rate
of depolarization of a specific region of the heart during
median ventricular rate.
C119258 EGHRMIN ECG Minimum Heart Rate An electrocardiographic measurement of the minimum Minimum Heart Rate by
minimum ventricular rate.
C119259 EGHRMN ECG Mean Heart Rate An electrocardiographic measurement of the average rate Mean Heart Rate by
of depolarization of a specific region of the heart during Electrocardiogram
mean ventricular rate.
C120608 EGHRSI Single RR Heart Rate An electrocardiographic measurement of a heart rate Single Beat RR
derived from a single RR interval (interval between two Extrapolated Heart Rate
consecutive QRS complexes). by ECG Assessment
C119260 EGVRMAX ECG Maximum Ventricular An electrocardiographic measurement of the maximum Maximum Ventricular
Rate rate of ventricular depolarizations (QRS complexes) Rate by
recorded during an interval of time, usually expressed in Electrocardiogram
beats per minute.
page 453 of 1925

C71153 EGTESTCD
Code Value
C119261 EGVRMED ECG Median Ventricular An electrocardiographic measurement of the median rate Median Ventricular Rate
Rate of ventricular depolarizations (QRS complexes) recorded by Electrocardiogram
minute.
C119262 EGVRMIN ECG Minimum Ventricular An electrocardiographic measurement of the minimum Minimum Ventricular Rate
Rate rate of ventricular depolarizations (QRS complexes) by Electrocardiogram
recorded during an interval of time, usually expressed in
beats per minute.
C119263 EGVRMN ECG Mean Ventricular An electrocardiographic measurement of the average rate Mean Ventricular Rate by
Rate of ventricular depolarizations (QRS complexes) recorded Electrocardiogram
minute.

formal language.
C111238 IVTIACD Intraventricular- An electrocardiographic assessment of intraventricular Intraventricular and

Intraatrial Conduction and intra-atrial conduction. Intraatrial Conduction
ECG Assessment
C117762 JTAG JT Interval, Aggregate An aggregate JT value based on the measurement of JT Aggregate JT Interval
C117763 JTCBAG JTcB Interval, Aggregate A JT aggregate interval that is corrected for heart rate Aggregate JTCB Interval
C117764 JTCBSB JTcB Interval, Single Beat A JT single beat interval that is corrected for heart rate Single Beat JTCB Interval
using Bazett's formula, based on a QT interval measured
C117765 JTCFAG JTcF Interval, Aggregate A JT aggregate interval that is corrected for heart rate Aggregate JTCF Interval
C117766 JTCFSB JTcF Interval, Single Beat A JT single beat interval that is corrected for heart rate Single Beat JTCF Interval
using Fridericia's formula, based on a QT interval
leads.
C62117 JTMAX Summary (Max) JT The maximum duration (time) of the JT interval, obtained Maximum JT Duration
Interval from a set of measurements of the JT interval. The JT
C62116 JTMIN Summary (Min) JT The minimum duration (time) of the JT interval, obtained Minimum JT Duration
Interval from a set of measurements of the JT interval. The JT
C117767 JTPAG J-Tpeak Interval, An aggregate J-Tpeak value based on the measurement Aggregate J-T Peak
Aggregate of J-Tpeak intervals from multiple beats within a single Interval
ECG. The method of aggregation, which can vary, is
typically a measure of central tendency such as the
mean.
C117768 JTPSB J-Tpeak Interval, Single An electrocardiographic interval measured from the J Single Beat J-T Peak
Beat point to the peak of the T wave of a single beat utilizing Interval
one or more leads.
C117769 JTSB JT Interval, Single Beat An electrocardiographic interval measured from the J Single Beat JT Interval
point to the offset of the T wave of a single beat utilizing
one or more leads.
C111280 MI Myocardial Infarction An electrocardiographic assessment of findings suggestive Myocardial Infarction ECG
page 454 of 1925

C71153 EGTESTCD
Code Value
C117770 NEWQWAVE New Q Wave An electrocardiographic finding assessment of new or New Q Wave
presumed new pathologic Q waves suggestive of
myocardial infarction. (Thygesen K, Alpert JS, Jaffe AS,
Simoons ML, et al.; Joint ESC/ACCF/AHA/WHF Task Force
for Universal Definition of Myocardial Infarction. Third
universal definition of myocardial infarction. J Am Coll
Cardiol. 2012 Oct 16;60(16):1581-98).
C118164 P_AXIS P Wave Axis A numerical representation of the electrocardiographic P Wave Axis
vector assessed at maximum deviation of the P wave
frontal plane.
C111285 PACEMAKR Pacemaker An electrocardiographic assessment of presence of Pacemaker ECG

C117771 PPAG PP Interval, Aggregate An aggregate PP value based on the measurement of PP Aggregate PP Interval
C117772 PPSM PP Interval, Single An electrocardiographic measurement of the interval Single Measurement PP
Measurement between the onsets of two consecutive P waves. Interval
C117773 PRAG PR Interval, Aggregate An aggregate PR value based on the measurement of PR Aggregate PR Interval
C62131 PRMAX Summary (Max) PR The maximum duration (time) of the PR interval, Maximum PR Duration
Duration obtained from a set of measurements of the PR interval.
The PR interval is defined as the time from the beginning
of the P wave (representing the onset of atrial
depolarization) to the beginning of the R wave
(representing the onset of ventricular depolarization). In
some cases, a Q wave will precede the R wave, in which
case the PR interval is measured from the beginning of
the P wave to the beginning of the Q wave. (NCI)
C62125 PRMIN Summary (Min) PR The minimum duration (time) of the PR interval, obtained Minimum PR Duration
Duration from a set of measurements of the PR interval. The PR
interval is defined as the time from the beginning of the P
wave (representing the onset of atrial depolarization) to
the beginning of the R wave (representing the onset of
ventricular depolarization). In some cases, a Q wave will
precede the R wave, in which case the PR interval is
measured from the beginning of the P wave to the
beginning of the Q wave. (NCI)
C117774 PRSB PR Interval, Single Beat An electrocardiographic interval measured from the onset Single Beat PR Interval
of the P wave to the onset of the QRS complex of a single
C117775 PWDURAG P Wave Duration, An aggregate P wave duration value based on the Aggregate P Wave
Aggregate measurement of P wave duration intervals from multiple Duration
such as the mean.
C117776 PWDURSB P Wave Duration, Single An electrocardiographic interval measured from the onset Single Beat P Wave
Beat of the P wave to the offset of the P wave of a single beat Duration
C117777 PWHTAG P Wave Amplitude, An aggregate P wave amplitude value based on the Aggregate P Wave
Aggregate measurement of P wave amplitudes from multiple beats Amplitude
as the mean.
C117778 PWHTSB P Wave Amplitude, Single An electrocardiographic measurement of the mean Single Beat P Wave
Beat amplitude (usually measured in mV) of the P wave Amplitude
P wave of a single beat utilizing one or more leads. Based
reported in mm.
C118165 QRS_AXIS QRS Axis A numerical representation of the electrocardiographic QRS Axis
vector assessed at maximum deviation of the QRS
complex from the isoelectric baseline, usually reported for
the frontal plane.
C117779 QRSAG QRS Duration, Aggregate An aggregate QRS value based on the measurement of Aggregate QRS Duration
QRS intervals from multiple beats within a single ECG.
page 455 of 1925

C71153 EGTESTCD
Code Value
C117780 QRSSB QRS Duration, Single An electrocardiographic interval measured from the onset Single Beat QRS Duration
Beat of the QRS complex to the offset of the QRS complex of a
single beat utilizing one or more leads.
C117781 QRVDVPAG QRS Duration, Ventr. An aggregate paced QRS duration value based on the Paced Ventricular
Paced, Aggregate measurement of paced QRS duration intervals from Aggregate QRS Duration
C117782 QRVDVPSB QRS Duration, Ventr. An electrocardiographic interval measured from the onset Paced Ventricular Single
Paced, Single Beat of the paced QRS complex to the offset of the QRS Beat QRS Duration
complex of a single beat utilizing one or more leads.
C117783 QTAG QT Interval, Aggregate An aggregate QT value based on the measurement of QT Aggregate QT Interval
C124332 QTCAAG QTca Interval, Aggregate A QT Aggregate interval that is corrected for heart rate Aggregate QTca Interval
using individual probabilistic QT/RR slopes for each
subject, based on the measurement of QT intervals from
multiple beats within a single ECG or period of a
continuous ECG. The method of aggregation, which can
vary, is typically a measure of central tendency such as
the mean.
C124333 QTCASB QTca Interval, Single A QT interval that is corrected for heart rate using Single Beat QTca Interval
Beat individual probabilistic QT/RR slopes for each subject,
based on a QT interval measured on a single beat utilizing
one or more ECG leads.
C117784 QTCBAG QTcB Interval, Aggregate A QT aggregate interval that is corrected for heart rate Aggregate QTCB Interval
C117785 QTCBSB QTcB Interval, Single A QT single beat interval that is corrected for heart rate Single Beat QTCB Interval
Beat using Bazett's formula, based on a QT interval measured
C117786 QTCFAG QTcF Interval, Aggregate A QT aggregate interval that is corrected for heart rate Aggregate QTCF Interval
C117787 QTCFSB QTcF Interval, Single A QT single beat interval that is corrected for heart rate Single Beat QTCF Interval
Beat using Fridericia's formula, based on a QT interval
leads.
C123448 QTCLAG QTcL Interval, Aggregate A QT aggregate interval corrected for heart rate using a Aggregate QTcL Interval
C123449 QTCLSB QTcL Interval, Single Beat A QT single beat interval corrected for heart rate using a Single Beat QTcL Interval
C100391 QTCUNS QTc Correction Method A QT interval that is corrected for heart rate by Corrected QT Interval
Unspecified unspecified correction method.
C123450 QTCVAG QTcV Interval, Aggregate A QT aggregate interval corrected for heart rate using the Aggregate QTcV Interval
Van der Water's correction formula.
C123451 QTCVSB QTcV Interval, Single A QT single beat interval corrected for heart rate using Single Beat QTcV Interval
Beat the Van der Water's correction formula.
C62135 QTMAX Summary (Max) QT The maximum duration (time) of the QT interval, Maximum QT Duration
Duration obtained from a set of measurements of the QT interval.
The QT interval is defined as the time from the beginning
of the QRS complex to the end of the T wave,
representing the time it takes for the ventricles to
depolarize and subsequently repolarize. In some cases,
the Q wave will be absent, in which case the QT interval
is measured from the beginning of the R wave to the end
of the T wave. (NCI)
page 456 of 1925

C71153 EGTESTCD
Code Value
C62133 QTMIN Summary (Min) QT The minimum duration (time) of the QT interval, obtained Minimum QT Duration
Duration from a set of measurements of the QT interval. The QT
interval is defined as the time from the beginning of the
QRS complex to the end of the T wave, representing the
time it takes for the ventricles to depolarize and
subsequently repolarize. In some cases, the Q wave will
be absent, in which case the QT interval is measured
from the beginning of the R wave to the end of the T
wave. (NCI)
C117788 QTSB QT Interval, Single Beat An electrocardiographic interval measured from the onset Single Beat QT Interval
of the QRS complex to the offset of the T wave of a single
C117789 QWAAG Q Wave Amplitude, An aggregate Q wave amplitude value based on the Aggregate Q Wave
Aggregate measurement of Q wave amplitudes from multiple beats Amplitude
as the mean.
C117790 QWASB Q Wave Amplitude, Single An electrocardiographic measurement of the mean Single Beat Q Wave
Beat amplitude (usually measured in mV) of the Q wave Amplitude
Q wave of a single beat utilizing one or more leads. Based
reported in mm.
C111307 RHYNOS Rhythm Not Otherwise An electrocardiographic assessment of cardiac rhythm not Rhythm Not Otherwise
Specified otherwise specified. Specified ECG
Assessment
C117791 RRAG RR Interval, Aggregate An aggregate RR value based on the measurement of RR Aggregate RR Interval
C62094 RRMAX Summary (Max) RR The maximum duration (time) between successive peaks Maximum RR Duration
Duration of R waves in a particular set of RR intervals. (NCI)
C62093 RRMIN Summary (Min) RR The minimum duration (time) between successive peaks Minimum RR Duration
Duration of R waves in a particular set of RR intervals. (NCI)
C117792 RRSM RR Interval, Single An electrocardiographic measurement of the interval RR Interval Single
Measurement between two consecutive R waves. If R waves are not Measurement
present, this measurement may utilize the interval
between the most easily identified components of the
QRS complex within two consecutive beats.
C117793 RSAAG RS Wave Amplitude, An aggregate RS wave amplitude value based on RS Wave Amplitude
Aggregate measurements from multiple beats from a single ECG. Aggregate
C117794 RSASB RS Wave Amplitude, An electrocardiographic measurement of the sum of the RS Wave Amplitude
Single Beat amplitudes of the R and S waves, obtained from a single Single Beat
beat in one particular lead or set of leads.
C117795 RWAAG R Wave Amplitude, An aggregate R wave amplitude value based on the R Wave Amplitude
Aggregate measurement of R wave amplitudes from multiple beats Aggregate
as the mean.
C117796 RWASB R Wave Amplitude, Single An electrocardiographic measurement of the mean R Wave Amplitude Single
Beat amplitude (usually measured in mV) of the R wave Beat
R wave of a single beat utilizing one or more leads. Based
reported in mm.
C111312 SNRARRY Sinus Node Rhythms and An electrocardiographic assessment of sinus node Sinus Node Rhythm and
Arrhythmias rhythms and arrhythmias. Arrhythmia ECG
Assessment
C111320 SPRARRY Supraventricular An electrocardiographic assessment of supraventricular Supraventricular

Arrhythmias arrhythmias excluding tachycardias. Arrhythmia ECG
Assessment
C111321 SPRTARRY Supraventricular An electrocardiographic assessment of supraventricular Supraventricular

Tachyarrhythmias tachyarrhythmias. Tachyarrhythmia ECG
Assessment
page 457 of 1925

C71153 EGTESTCD
Code Value
C117797 STDAG ST Segment Depression, An aggregate ST segment depression value based on the ST Segment Depression
Aggregate measurement of ST segment depression from multiple Aggregate
such as the mean.
C62163 STDPMAX Summary (Max) ST The maximum depression (negative deflection from Maximum ST Segment
Depression baseline, usually measured in mm) of the ST segment, Depression by ECG
C62162 STDPMIN Summary (Min) ST The minimum depression (negative deflection from Minimum ST Segment
Depression baseline, usually measured in mm) of the ST segment, Depression by ECG
C117798 STDSB ST Segment Depression, An electrocardiographic measurement of the mean ST Segment Depression
Single Beat amplitude (usually measured in mV) of the ST segment Single Beat
depression below the isoelectric baseline measured from
C117799 STDVAG ST Segment Deviation, An aggregate ST segment deviation value based on the ST Segment Deviation
Aggregate measurement of ST segment deviation from multiple Aggregate
such as the mean.
C62157 STDVMAX Summary (Max) ST The maximum deviation (distance from baseline, positive Maximum ST Deviation
Deviation or negative, usually measured in mm) of the ST segment,
C62156 STDVMIN Summary (Min) ST The minimum deviation (distance from baseline, positive Minimum ST Deviation
Deviation or negative, usually measured in mm) of the ST segment,
C117800 STDVSB ST Segment Deviation, An electrocardiographic measurement of the mean ST Segment Deviation
deviation above or below the isoelectric baseline
measured from the baseline to the ST segment of a single
beat utilizing one or more leads. Based on the recording
gain, this measurement may also be reported in mm.
C117801 STEAG ST Segment Elevation, An aggregate ST segment elevation value based on the ST Segment Elevation
Aggregate measurement of ST segment elevation from multiple Aggregate
such as the mean.
C62160 STELMAX Summary (Max) ST The maximum elevation (positive deflection from Maximum ST Segment
Elevation baseline, usually measured in mm) of the ST segment, Elevation
obtained from a set of measurements of the elevation of
C62159 STELMIN Summary (Min) ST The minimum elevation (positive deflection from baseline, Minimum ST Segment
Elevation usually measured in mm) of the ST segment, obtained Elevation
from a set of measurements of the elevation of the ST
segment. (NCI)
C117802 STESB ST Segment Elevation, An electrocardiographic measurement of the mean ST Segment Elevation
elevation above the isoelectric baseline measured from
C117803 STSDURAG ST Segment Duration, An aggregate ST segment duration value based on the ST Segment Duration
Aggregate measurement of ST segment duration intervals from Aggregate
C117804 STSDURSB ST Segment Duration, An electrocardiographic interval measured from the J ST Segment Duration
Single Beat point to the onset of the T wave of a single beat utilizing Single Beat
one or more leads.
C111363 STSTWUW ST Segment, T wave, and An electrocardiographic assessment of the characteristics ST Segment, T wave, and
U wave of the ST segment, T wave, and U wave. U wave ECG Assessment
page 458 of 1925

C71153 EGTESTCD
Code Value
C117805 SWAAG S Wave Amplitude, An aggregate S wave amplitude value based on the S Wave Amplitude
Aggregate measurement of S wave amplitudes from multiple beats Aggregate
as the mean.
C117806 SWASB S Wave Amplitude, Single An electrocardiographic measurement of the mean S Wave Amplitude Single
Beat amplitude (usually measured in mV) of the S wave Beat
S wave of a single beat utilizing one or more leads. Based
reported in mm.
C118166 T_AXIS T Wave Axis A numerical representation of the electrocardiographic T Wave Axis
vector assessed at maximum deviation of the T wave
frontal plane.
C117807 TECHQUAL Technical Quality A statement about an electrocardiographic recording ECG Technical Quality
C117808 TPTEAG Tpeak-Tend Interval, An aggregate Tpeak-Tend value based on the T Peak-T End Interval
Aggregate measurement of Tpeak-Tend from multiple beats within a Aggregate
single ECG. The method of aggregation, which can vary,
mean.
C117809 TPTESB Tpeak-Tend Interval, An electrocardiographic interval measured from the peak T Peak-T End Interval
Single Beat of the T wave to the offset of the T wave of a single beat Single Beat
C117810 TWARAG T Wave Area, Aggregate An aggregate T wave area value based on the T Wave Area Aggregate
measurement of T wave areas from multiple beats within
a single ECG. The method of aggregation, which can vary,
mean.
C117811 TWARSB T Wave Area, Single Beat An electrocardiographic measurement of the area of the T T Wave Area Single Beat
wave of a single beat utilizing one or more leads.
C117812 TWDURAG T Wave Duration, An aggregate T wave duration value based on the T Wave Duration
Aggregate measurement of T wave duration intervals from multiple Aggregate
such as the mean.
C117813 TWDURSB T Wave Duration, Single An electrocardiographic interval measured from the onset T Wave Duration Single
Beat of the T wave to the offset of the T wave of a single beat Beat
C117814 TWHAG T Wave Amplitude, An aggregate T wave amplitude value based on the T Wave Amplitude
Aggregate measurement of T wave amplitudes from multiple beats Aggregate
as the mean.
C117815 TWHSB T Wave Amplitude, Single An electrocardiographic measurement of the mean T Wave Amplitude Single
Beat amplitude (usually measured in mV) of the T wave Beat
T wave of a single beat utilizing one or more leads. Based
reported in mm.
C111330 VTARRY Ventricular Arrhythmias An electrocardiographic assessment of ventricular Ventricular Arrhythmia

C111331 VTTARRY Ventricular An electrocardiographic assessment of ventricular Ventricular

Assessment
page 459 of 1925

EMO1TC (Emotion Recognition Functional Test Test Code)
C150768 EMO1TC
Code Value
C150926 EMO101 EMO1-Total Stimuli Emotion Recognition - Total number of stimuli (face ERT - Total Stimuli
Expected images) expected to be administered in the task. Expected
Administered images) actually administered in the task. Administered
Completed images) actually completed in the task. Completed
C150929 EMO103A EMO1-Total Stimuli Emotion Recognition - Total number of stimuli (face ERT - Total Stimuli
Response Correct images) for which the participant's response was correct. Response Correct
C150930 EMO103B EMO1-Total Stimuli Emotion Recognition - Total number of stimuli (face ERT - Total Stimuli
Response Incorrect images) for which the participant's response was Response Incorrect
incorrect.
C150931 EMO103C EMO1-Total Stimuli Not Emotion Recognition - Total number of stimuli (face ERT - Total Stimuli Not
Responded images) for which the participant has not responded. Responded
C150932 EMO104 EMO1-Total Negative Emotion Recognition - Total number of negative emotion ERT - Total Negative
Stimuli Expected stimuli (face images) expected to be administered in the Stimuli Expected
task.
Stimuli Administered stimuli (face images) actually administered in the task. Stimuli Administered
Stimuli Completed stimuli (face images) actually completed in the task. Stimuli Completed
C150935 EMO106A EMO1-Total Negative Emotion Recognition - Total number of negative emotion ERT - Total Negative
Stimuli Correct stimuli (face images) for which the participant's response Stimuli Correct
was correct.
C150936 EMO106B EMO1-Total Negative Emotion Recognition - Total number of negative emotion ERT - Total Negative
Stimuli Incorrect stimuli (face images) for which the participant's response Stimuli Incorrect
was incorrect.
C150937 EMO106C EMO1-Total Negative Emotion Recognition - Total number of negative emotion ERT - Total Negative
Stimuli Not Respond stimuli (face images) for which the participant has not Stimuli Not Respond
responded.
C150938 EMO107 EMO1-Number Stimuli Emotion Recognition - Number of stimuli defined as ERT - Number Stimuli
Portraying Anger portraying anger. Portraying Anger
C150939 EMO107A EMO1-Anger Responded Emotion Recognition - Number of anger stimuli responded ERT - Anger Responded
as Anger to as anger. as Anger
C150940 EMO107B EMO1-Anger Responded Emotion Recognition - Number of anger stimuli responded ERT - Anger Responded
as Disgust to as disgust. as Disgust
C150941 EMO107C EMO1-Anger Responded Emotion Recognition - Number of anger stimuli responded ERT - Anger Responded
as Fear to as fear. as Fear
C150942 EMO107D EMO1-Anger Responded Emotion Recognition - Number of anger stimuli responded ERT - Anger Responded
as Happiness to as happiness. as Happiness
C150943 EMO107E EMO1-Anger Responded Emotion Recognition - Number of anger stimuli responded ERT - Anger Responded
as Neutral to as neutral. as Neutral
C150944 EMO107F EMO1-Anger Responded Emotion Recognition - Number of anger stimuli responded ERT - Anger Responded
as Sadness to as sadness. as Sadness
C150945 EMO107G EMO1-Anger Responded Emotion Recognition - Number of anger stimuli responded ERT - Anger Responded
as Surprise to as surprise. as Surprise
Portraying Disgust portraying disgust. Portraying Disgust
C150947 EMO108A EMO1-Disgust Responded Emotion Recognition - Number of disgust stimuli ERT - Disgust Responded
as Anger responded to as anger. as Anger
C150948 EMO108B EMO1-Disgust Responded Emotion Recognition - Number of disgust stimuli ERT - Disgust Responded
as Disgust responded to as disgust. as Disgust
C150949 EMO108C EMO1-Disgust Responded Emotion Recognition - Number of disgust stimuli ERT - Disgust Responded
as Fear responded to as fear. as Fear
page 460 of 1925

C150768 EMO1TC
Code Value
C150950 EMO108D EMO1-Disgust Responded Emotion Recognition - Number of disgust stimuli ERT - Disgust Responded
as Happiness responded to as happiness. as Happiness
C150951 EMO108E EMO1-Disgust Responded Emotion Recognition - Number of disgust stimuli ERT - Disgust Responded
as Neutral responded to as neutral. as Neutral
C150952 EMO108F EMO1-Disgust Responded Emotion Recognition - Number of disgust stimuli ERT - Disgust Responded
as Sadness responded to as sadness. as Sadness
C150953 EMO108G EMO1-Disgust Responded Emotion Recognition - Number of disgust stimuli ERT - Disgust Responded
as Surprise responded to as surprise. as Surprise
Portraying Fear portraying fear. Portraying Fear
C150955 EMO109A EMO1-Fear Responded as Emotion Recognition - Number of fear stimuli responded ERT - Fear Responded as
Anger to as anger. Anger
C150956 EMO109B EMO1-Fear Responded as Emotion Recognition - Number of fear stimuli responded ERT - Fear Responded as
Disgust to as disgust. Disgust
C150957 EMO109C EMO1-Fear Responded as Emotion Recognition - Number of fear stimuli responded ERT - Fear Responded as
Fear to as fear. Fear
C150958 EMO109D EMO1-Fear Responded as Emotion Recognition - Number of fear stimuli responded ERT - Fear Responded as
Happiness to as happiness. Happiness
C150959 EMO109E EMO1-Fear Responded as Emotion Recognition - Number of fear stimuli responded ERT - Fear Responded as
Neutral to as neutral. Neutral
C150960 EMO109F EMO1-Fear Responded as Emotion Recognition - Number of fear stimuli responded ERT - Fear Responded as
Sadness to as sadness. Sadness
C150961 EMO109G EMO1-Fear Responded as Emotion Recognition - Number of fear stimuli responded ERT - Fear Responded as
Surprise to as surprise. Surprise
Portraying Happiness portraying happiness. Portraying Happiness
C150963 EMO110A EMO1-Happiness Emotion Recognition - Number of happiness stimuli ERT - Happiness
Responded as Anger responded to as anger. Responded as Anger
C150964 EMO110B EMO1-Happiness Emotion Recognition - Number of happiness stimuli ERT - Happiness
Responded as Disgust responded to as disgust. Responded as Disgust
C150965 EMO110C EMO1-Happiness Emotion Recognition - Number of happiness stimuli ERT - Happiness
Responded as Fear responded to as fear. Responded as Fear
C150966 EMO110D EMO1-Happiness Emotion Recognition - Number of happiness stimuli ERT - Happiness
Responded as Happiness responded to as happiness. Responded as Happiness
C150967 EMO110E EMO1-Happiness Emotion Recognition - Number of happiness stimuli ERT - Happiness
Responded as Neutral responded to as neutral. Responded as Neutral
C150968 EMO110F EMO1-Happiness Emotion Recognition - Number of happiness stimuli ERT - Happiness
Responded as Sadness responded to as sadness. Responded as Sadness
C150969 EMO110G EMO1-Happiness Emotion Recognition - Number of happiness stimuli ERT - Happiness
Responded as Surprise responded to as surprise. Responded as Surprise
Portraying Neutral portraying a neutral expression. Portraying Neutral
C150971 EMO111A EMO1-Neutral Responded Emotion Recognition - Number of neutral stimuli ERT - Neutral Responded
as Anger responded to as anger. as Anger
C150972 EMO111B EMO1-Neutral Responded Emotion Recognition - Number of neutral stimuli ERT - Neutral Responded
as Disgust responded to as disgust. as Disgust
C150973 EMO111C EMO1-Neutral Responded Emotion Recognition - Number of neutral stimuli ERT - Neutral Responded
as Fear responded to as fear. as Fear
C150974 EMO111D EMO1-Neutral Responded Emotion Recognition - Number of neutral stimuli ERT - Neutral Responded
as Happiness responded to as happiness. as Happiness
C150975 EMO111E EMO1-Neutral Responded Emotion Recognition - Number of neutral stimuli ERT - Neutral Responded
as Neutral responded to as neutral. as Neutral
C150976 EMO111F EMO1-Neutral Responded Emotion Recognition - Number of neutral stimuli ERT - Neutral Responded
as Sadness responded to as sadness. as Sadness
page 461 of 1925

C150768 EMO1TC
Code Value
C150977 EMO111G EMO1-Neutral Responded Emotion Recognition - Number of neutral stimuli ERT - Neutral Responded
as Surprise responded to as surprise. as Surprise
Portraying Sadness portraying sadness. Portraying Sadness
C150979 EMO112A EMO1-Sadness Emotion Recognition - Number of sadness stimuli ERT - Sadness Responded
Responded as Anger responded to as anger. as Anger
C150980 EMO112B EMO1-Sadness Emotion Recognition - Number of sadness stimuli ERT - Sadness Responded
Responded as Disgust responded to as disgust. as Disgust
C150981 EMO112C EMO1-Sadness Emotion Recognition - Number of sadness stimuli ERT - Sadness Responded
Responded as Fear responded to as fear. as Fear
C150982 EMO112D EMO1-Sadness Emotion Recognition - Number of sadness stimuli ERT - Sadness Responded
Responded as Happiness responded to as happiness. as Happiness
C150983 EMO112E EMO1-Sadness Emotion Recognition - Number of sadness stimuli ERT - Sadness Responded
Responded as Neutral responded to as neutral. as Neutral
C150984 EMO112F EMO1-Sadness Emotion Recognition - Number of sadness stimuli ERT - Sadness Responded
Responded as Sadness responded to as sadness. as Sadness
C150985 EMO112G EMO1-Sadness Emotion Recognition - Number of sadness stimuli ERT - Sadness Responded
Responded as Surprise responded to as surprise. as Surprise
Portraying Surprise portraying surprise. Portraying Surprise
C150987 EMO113A EMO1-Surprise Emotion Recognition - Number of surprise stimuli ERT - Surprise Responded
Responded as Anger responded to as anger. as Anger
C150988 EMO113B EMO1-Surprise Emotion Recognition - Number of surprise stimuli ERT - Surprise Responded
Responded as Disgust responded to as disgust. as Disgust
C150989 EMO113C EMO1-Surprise Emotion Recognition - Number of surprise stimuli ERT - Surprise Responded
Responded as Fear responded to as fear. as Fear
C150990 EMO113D EMO1-Surprise Emotion Recognition - Number of surprise stimuli ERT - Surprise Responded
Responded as Happiness responded to as happiness. as Happiness
C150991 EMO113E EMO1-Surprise Emotion Recognition - Number of surprise stimuli ERT - Surprise Responded
Responded as Neutral responded to as neutral. as Neutral
C150992 EMO113F EMO1-Surprise Emotion Recognition - Number of surprise stimuli ERT - Surprise Responded
Responded as Sadness responded to as sadness. as Sadness
C150993 EMO113G EMO1-Surprise Emotion Recognition - Number of surprise stimuli ERT - Surprise Responded
Responded as Surprise responded to as surprise. as Surprise
page 462 of 1925

EMO1TN (Emotion Recognition Functional Test Test Name)
C150767 EMO1TN
Code Value
C150939 EMO1-Anger Responded EMO1-Anger Responded Emotion Recognition - Number of anger stimuli responded ERT - Anger Responded
as Anger as Anger to as anger. as Anger
as Disgust as Disgust to as disgust. as Disgust
as Fear as Fear to as fear. as Fear
as Happiness as Happiness to as happiness. as Happiness
as Neutral as Neutral to as neutral. as Neutral
as Sadness as Sadness to as sadness. as Sadness
as Surprise as Surprise to as surprise. as Surprise
C150947 EMO1-Disgust Responded EMO1-Disgust Responded Emotion Recognition - Number of disgust stimuli ERT - Disgust Responded
as Anger as Anger responded to as anger. as Anger
as Disgust as Disgust responded to as disgust. as Disgust
as Fear as Fear responded to as fear. as Fear
as Happiness as Happiness responded to as happiness. as Happiness
as Neutral as Neutral responded to as neutral. as Neutral
as Sadness as Sadness responded to as sadness. as Sadness
as Surprise as Surprise responded to as surprise. as Surprise
C150955 EMO1-Fear Responded as EMO1-Fear Responded as Emotion Recognition - Number of fear stimuli responded ERT - Fear Responded as
Anger Anger to as anger. Anger
Disgust Disgust to as disgust. Disgust
Fear Fear to as fear. Fear
Happiness Happiness to as happiness. Happiness
Neutral Neutral to as neutral. Neutral
Sadness Sadness to as sadness. Sadness
Surprise Surprise to as surprise. Surprise
C150963 EMO1-Happiness EMO1-Happiness Emotion Recognition - Number of happiness stimuli ERT - Happiness
Responded as Anger Responded as Anger responded to as anger. Responded as Anger
Responded as Disgust Responded as Disgust responded to as disgust. Responded as Disgust
Responded as Fear Responded as Fear responded to as fear. Responded as Fear
Responded as Happiness Responded as Happiness responded to as happiness. Responded as Happiness
Responded as Neutral Responded as Neutral responded to as neutral. Responded as Neutral
page 463 of 1925

C150767 EMO1TN
Code Value
Responded as Sadness Responded as Sadness responded to as sadness. Responded as Sadness
Responded as Surprise Responded as Surprise responded to as surprise. Responded as Surprise
C150971 EMO1-Neutral Responded EMO1-Neutral Responded Emotion Recognition - Number of neutral stimuli ERT - Neutral Responded
as Anger as Anger responded to as anger. as Anger
as Disgust as Disgust responded to as disgust. as Disgust
as Fear as Fear responded to as fear. as Fear
as Happiness as Happiness responded to as happiness. as Happiness
as Neutral as Neutral responded to as neutral. as Neutral
as Sadness as Sadness responded to as sadness. as Sadness
as Surprise as Surprise responded to as surprise. as Surprise
C150938 EMO1-Number Stimuli EMO1-Number Stimuli Emotion Recognition - Number of stimuli defined as ERT - Number Stimuli
Portraying Anger Portraying Anger portraying anger. Portraying Anger
Portraying Disgust Portraying Disgust portraying disgust. Portraying Disgust
Portraying Fear Portraying Fear portraying fear. Portraying Fear
Portraying Happiness Portraying Happiness portraying happiness. Portraying Happiness
Portraying Neutral Portraying Neutral portraying a neutral expression. Portraying Neutral
Portraying Sadness Portraying Sadness portraying sadness. Portraying Sadness
Portraying Surprise Portraying Surprise portraying surprise. Portraying Surprise
C150979 EMO1-Sadness EMO1-Sadness Emotion Recognition - Number of sadness stimuli ERT - Sadness Responded
Responded as Anger Responded as Anger responded to as anger. as Anger
Responded as Disgust Responded as Disgust responded to as disgust. as Disgust
Responded as Fear Responded as Fear responded to as fear. as Fear
Responded as Happiness Responded as Happiness responded to as happiness. as Happiness
Responded as Neutral Responded as Neutral responded to as neutral. as Neutral
Responded as Sadness Responded as Sadness responded to as sadness. as Sadness
Responded as Surprise Responded as Surprise responded to as surprise. as Surprise
C150987 EMO1-Surprise EMO1-Surprise Emotion Recognition - Number of surprise stimuli ERT - Surprise Responded
Responded as Anger Responded as Anger responded to as anger. as Anger
Responded as Disgust Responded as Disgust responded to as disgust. as Disgust
Responded as Fear Responded as Fear responded to as fear. as Fear
Responded as Happiness Responded as Happiness responded to as happiness. as Happiness
page 464 of 1925

C150767 EMO1TN
Code Value
Responded as Neutral Responded as Neutral responded to as neutral. as Neutral
Responded as Sadness Responded as Sadness responded to as sadness. as Sadness
Responded as Surprise Responded as Surprise responded to as surprise. as Surprise
C150933 EMO1-Total Negative EMO1-Total Negative Emotion Recognition - Total number of negative emotion ERT - Total Negative
Stimuli Administered Stimuli Administered stimuli (face images) actually administered in the task. Stimuli Administered
Stimuli Completed Stimuli Completed stimuli (face images) actually completed in the task. Stimuli Completed
Stimuli Correct Stimuli Correct stimuli (face images) for which the participant's response Stimuli Correct
was correct.
Stimuli Expected Stimuli Expected stimuli (face images) expected to be administered in the Stimuli Expected
task.
Stimuli Incorrect Stimuli Incorrect stimuli (face images) for which the participant's response Stimuli Incorrect
was incorrect.
Stimuli Not Respond Stimuli Not Respond stimuli (face images) for which the participant has not Stimuli Not Respond
responded.
C150927 EMO1-Total Stimuli EMO1-Total Stimuli Emotion Recognition - Total number of stimuli (face ERT - Total Stimuli
Administered Administered images) actually administered in the task. Administered
Completed Completed images) actually completed in the task. Completed
Expected Expected images) expected to be administered in the task. Expected
C150931 EMO1-Total Stimuli Not EMO1-Total Stimuli Not Emotion Recognition - Total number of stimuli (face ERT - Total Stimuli Not
Responded Responded images) for which the participant has not responded. Responded
Response Correct Response Correct images) for which the participant's response was correct. Response Correct
Response Incorrect Response Incorrect images) for which the participant's response was Response Incorrect
incorrect.
page 465 of 1925

EMPSTAT (Employment Status)
C111108 EMPSTAT
Code Value
C52658 FULL-TIME Employment involving the standard or customary working Full Time Employment
time.
C75563 NOT EMPLOYED The state of not having a job. Unemployment
C75562 PART-TIME Employment involving less than the standard or Part Time Employment
customary working time.
page 466 of 1925

EPDS01TC (Edinburgh Postnatal Depression Scale Questionnaire Test Code)
C132521 EPDS01TC
Code Value
C132563 EPDS0101 EPDS01-Able to Laugh Edinburgh Postnatal Depression Scale - I have been able EPDS - Able to Laugh and
and See Funny Side to laugh and see the funny side of things. See Funny Side
C132564 EPDS0102 EPDS01-Looked Forward Edinburgh Postnatal Depression Scale - I have looked EPDS - Looked Forward
With Enjoyment forward with enjoyment to things. With Enjoyment
C132565 EPDS0103 EPDS01-Blamed Myself Edinburgh Postnatal Depression Scale - I have blamed EPDS - Blamed Myself
Unnecessarily myself unnecessarily when things went wrong. Unnecessarily
C132566 EPDS0104 EPDS01-Anxious/Worried Edinburgh Postnatal Depression Scale - I have been EPDS - Anxious or
No Good Reason anxious or worried for no good reason. Worried No Good Reason
C132567 EPDS0105 EPDS01-Scared/Panicky Edinburgh Postnatal Depression Scale - I have felt scared EPDS - Scared or Panicky
for No Good Reason or panicky for no very good reason. for No Good Reason
C132568 EPDS0106 EPDS01-Things Getting Edinburgh Postnatal Depression Scale - Things have been EPDS - Things Getting on
on Top of Me getting on top of me. Top of Me
C132569 EPDS0107 EPDS01-Unhappy Had Edinburgh Postnatal Depression Scale - I have been so EPDS - Unhappy Had
Difficulty Sleeping unhappy that I have had difficulty sleeping. Difficulty Sleeping
C132570 EPDS0108 EPDS01-I Have Felt Sad Edinburgh Postnatal Depression Scale - I have felt sad or EPDS - I Have Felt Sad or
or Miserable miserable. Miserable
C132571 EPDS0109 EPDS01-So Unhappy I Edinburgh Postnatal Depression Scale - I have been so EPDS - So Unhappy I
Have Been Crying unhappy that I have been crying. Have Been Crying
C132572 EPDS0110 EPDS01-Thought of Edinburgh Postnatal Depression Scale - The thought of EPDS - Thought of
Harming Myself harming myself has occurred to me. Harming Myself
page 467 of 1925

EPDS01TN (Edinburgh Postnatal Depression Scale Questionnaire Test Name)
C132520 EPDS01TN
Code Value
C132563 EPDS01-Able to Laugh EPDS01-Able to Laugh Edinburgh Postnatal Depression Scale - I have been able EPDS - Able to Laugh and
and See Funny Side and See Funny Side to laugh and see the funny side of things. See Funny Side
C132566 EPDS01-Anxious/Worried EPDS01-Anxious/Worried Edinburgh Postnatal Depression Scale - I have been EPDS - Anxious or
No Good Reason No Good Reason anxious or worried for no good reason. Worried No Good Reason
C132565 EPDS01-Blamed Myself EPDS01-Blamed Myself Edinburgh Postnatal Depression Scale - I have blamed EPDS - Blamed Myself
Unnecessarily Unnecessarily myself unnecessarily when things went wrong. Unnecessarily
C132570 EPDS01-I Have Felt Sad EPDS01-I Have Felt Sad Edinburgh Postnatal Depression Scale - I have felt sad or EPDS - I Have Felt Sad or
or Miserable or Miserable miserable. Miserable
C132564 EPDS01-Looked Forward EPDS01-Looked Forward Edinburgh Postnatal Depression Scale - I have looked EPDS - Looked Forward
With Enjoyment With Enjoyment forward with enjoyment to things. With Enjoyment
C132567 EPDS01-Scared/Panicky EPDS01-Scared/Panicky Edinburgh Postnatal Depression Scale - I have felt scared EPDS - Scared or Panicky
for No Good Reason for No Good Reason or panicky for no very good reason. for No Good Reason
C132571 EPDS01-So Unhappy I EPDS01-So Unhappy I Edinburgh Postnatal Depression Scale - I have been so EPDS - So Unhappy I
Have Been Crying Have Been Crying unhappy that I have been crying. Have Been Crying
C132568 EPDS01-Things Getting EPDS01-Things Getting Edinburgh Postnatal Depression Scale - Things have been EPDS - Things Getting on
on Top of Me on Top of Me getting on top of me. Top of Me
C132572 EPDS01-Thought of EPDS01-Thought of Edinburgh Postnatal Depression Scale - The thought of EPDS - Thought of
Harming Myself Harming Myself harming myself has occurred to me. Harming Myself
C132569 EPDS01-Unhappy Had EPDS01-Unhappy Had Edinburgh Postnatal Depression Scale - I have been so EPDS - Unhappy Had
Difficulty Sleeping Difficulty Sleeping unhappy that I have had difficulty sleeping. Difficulty Sleeping
page 468 of 1925

EPIC1TC (The Expanded Prostate Cancer Index Composite Short Form Questionnaire Test Code)
C127350 EPIC1TC
Code Value
C127373 EPIC101 EPIC1-How Often Have The Expanded Prostate Cancer Index Composite Short EPIC-26 - How Often
You Leaked Urine Form - Over the past 4 weeks, how often have you leaked Have You Leaked Urine
urine?
C127374 EPIC102 EPIC1-Best Describes The Expanded Prostate Cancer Index Composite Short EPIC-26 - Best Describes
Urinary Control Form - Which of the following best describes your urinary Urinary Control
control during the last 4 weeks?
C127375 EPIC103 EPIC1-Pads or Adult The Expanded Prostate Cancer Index Composite Short EPIC-26 - Pads or Adult
Diapers per Day Form - How many pads or adult diapers per day did you Diapers per Day
usually use to control leakage during the last 4 weeks?
C127376 EPIC104A EPIC1-Problem Dripping The Expanded Prostate Cancer Index Composite Short EPIC-26 - Dripping or
or Leaking Urine Form - How big a problem, if any, has each of the Leaking Urine
following been for you during the last 4 weeks? Dripping
or leaking urine.
C127377 EPIC104B EPIC1-Problem The Expanded Prostate Cancer Index Composite Short EPIC-26 - Pain or Burning
Pain/Burning on Urination Form - How big a problem, if any, has each of the on Urination
following been for you during the last 4 weeks? Pain or
burning on urination.
C127378 EPIC104C EPIC1-Problem Bleeding The Expanded Prostate Cancer Index Composite Short EPIC-26 - Bleeding With
With Urination Form - How big a problem, if any, has each of the Urination
following been for you during the last 4 weeks? Bleeding
with urination.
C127379 EPIC104D EPIC1-Problem Weak The Expanded Prostate Cancer Index Composite Short EPIC-26 - Weak Urine
Urine Stream/Emptying Form - How big a problem, if any, has each of the Stream or Incomplete
following been for you during the last 4 weeks? Weak Emptying
urine stream or incomplete emptying.
C127380 EPIC104E EPIC1-Problem Need to The Expanded Prostate Cancer Index Composite Short EPIC-26 - Urinate
Urinate Frequently Form - How big a problem, if any, has each of the Frequently During the
following been for you during the last 4 weeks? Need to Day
urinate frequently during the day.
C127381 EPIC105 EPIC1-Overall Problem The Expanded Prostate Cancer Index Composite Short EPIC-26 - Overall
Urinary Function Form - Overall, how big a problem has your urinary Problem Urinary Function
function been for you during the last 4 weeks?
C127382 EPIC106A EPIC1-Problem Urgency The Expanded Prostate Cancer Index Composite Short EPIC-26 - Urgency to
of Bowel Movement Form - How big a problem, if any, has each of the Have a Bowel Movement
following been for you? Urgency to have a bowel
movement.
C127383 EPIC106B EPIC1-Problem Increased The Expanded Prostate Cancer Index Composite Short EPIC-26 - Increased
Freq Bowel Move Form - How big a problem, if any, has each of the Frequency of Bowel
following been for you? Increased frequency of bowel Movements
movements.
C127384 EPIC106C EPIC1-Problem Losing The Expanded Prostate Cancer Index Composite Short EPIC-26 - Losing Control
Control of Stools Form - How big a problem, if any, has each of the of Stools
following been for you? Losing control of your stools.
C127385 EPIC106D EPIC1-Problem Bloody The Expanded Prostate Cancer Index Composite Short EPIC-26 - Bloody Stools
Stools Form - How big a problem, if any, has each of the
following been for you? Bloody stools.
C127386 EPIC106E EPIC1-Problem The Expanded Prostate Cancer Index Composite Short EPIC-26 - Abdominal or
Abdom/Pelvic/Rectal Pain Form - How big a problem, if any, has each of the Pelvic or Rectal Pain
following been for you? Abdominal/pelvic/rectal pain.
Bowel Habits Form - Overall, how big a problem have your bowel Problem Bowel Habits
habits been for you during the last 4 weeks?
C127388 EPIC108A EPIC1-Rate Ability to The Expanded Prostate Cancer Index Composite Short EPIC-26 - Ability to Have
Have an Erection Form - How would you rate each of the following during an Erection
the last 4 weeks? Your ability to have an erection?
C127389 EPIC108B EPIC1-Rate Ability to The Expanded Prostate Cancer Index Composite Short EPIC-26 - Ability to Reach
Reach Orgasm Form - How would you rate each of the following during Orgasm
the last 4 weeks? Your ability to reach orgasm (climax)?
C127390 EPIC109 EPIC1-Quality of Your The Expanded Prostate Cancer Index Composite Short EPIC-26 - Quality of
Erections Form - How would you describe the usual quality of your Erections
erections during the last 4 weeks?
page 469 of 1925

C127350 EPIC1TC
Code Value
C127391 EPIC110 EPIC1-Frequency of Your The Expanded Prostate Cancer Index Composite Short EPIC-26 - Frequency of
Erections Form - How would you describe the frequency of your Erections
C127392 EPIC111 EPIC1-Rate Ability to The Expanded Prostate Cancer Index Composite Short EPIC-26 - Ability to
Function Sexually Form - Overall, how would you rate your ability to Function Sexually
function sexually during the last 4 weeks?
Sexual Function Form - Overall, how big a problem has your sexual Problem Sexual Function
function or lack of sexual function been for you during the
last 4 weeks?
C127394 EPIC113A EPIC1-Problem Hot The Expanded Prostate Cancer Index Composite Short EPIC-26 - Hot Flashes
Flashes Form - How big a problem during the last 4 weeks, if any,
has each of the following been for you? Hot flashes.
C127395 EPIC113B EPIC1-Problem Breast The Expanded Prostate Cancer Index Composite Short EPIC-26 - Breast Tender
Tender/Enlargement Form - How big a problem during the last 4 weeks, if any, or Enlargement
has each of the following been for you? Breast
tenderness/enlargement.
C127396 EPIC113C EPIC1-Problem Feeling The Expanded Prostate Cancer Index Composite Short EPIC-26 - Feeling
Depressed Form - How big a problem during the last 4 weeks, if any, Depressed
has each of the following been for you? Feeling
depressed.
C127397 EPIC113D EPIC1-Problem Lack of The Expanded Prostate Cancer Index Composite Short EPIC-26 - Lack of Energy
Energy Form - How big a problem during the last 4 weeks, if any,
has each of the following been for you? Lack of energy.
C127398 EPIC113E EPIC1-Problem Change in The Expanded Prostate Cancer Index Composite Short EPIC-26 - Change in Body
Body Weight Form - How big a problem during the last 4 weeks, if any, Weight
has each of the following been for you? Change in body
weight.
page 470 of 1925

EPIC1TN (The Expanded Prostate Cancer Index Composite Short Form Questionnaire Test Name)
C127349 EPIC1TN
Code Value
C127374 EPIC1-Best Describes EPIC1-Best Describes The Expanded Prostate Cancer Index Composite Short EPIC-26 - Best Describes
Urinary Control Urinary Control Form - Which of the following best describes your urinary Urinary Control
control during the last 4 weeks?
C127391 EPIC1-Frequency of Your EPIC1-Frequency of Your The Expanded Prostate Cancer Index Composite Short EPIC-26 - Frequency of
Erections Erections Form - How would you describe the frequency of your Erections
C127373 EPIC1-How Often Have EPIC1-How Often Have The Expanded Prostate Cancer Index Composite Short EPIC-26 - How Often
You Leaked Urine You Leaked Urine Form - Over the past 4 weeks, how often have you leaked Have You Leaked Urine
urine?
C127387 EPIC1-Overall Problem EPIC1-Overall Problem The Expanded Prostate Cancer Index Composite Short EPIC-26 - Overall
Bowel Habits Bowel Habits Form - Overall, how big a problem have your bowel Problem Bowel Habits
habits been for you during the last 4 weeks?
Sexual Function Sexual Function Form - Overall, how big a problem has your sexual Problem Sexual Function
function or lack of sexual function been for you during the
last 4 weeks?
Urinary Function Urinary Function Form - Overall, how big a problem has your urinary Problem Urinary Function
function been for you during the last 4 weeks?
C127375 EPIC1-Pads or Adult EPIC1-Pads or Adult The Expanded Prostate Cancer Index Composite Short EPIC-26 - Pads or Adult
Diapers per Day Diapers per Day Form - How many pads or adult diapers per day did you Diapers per Day
usually use to control leakage during the last 4 weeks?
C127386 EPIC1-Problem EPIC1-Problem The Expanded Prostate Cancer Index Composite Short EPIC-26 - Abdominal or
Abdom/Pelvic/Rectal Pain Abdom/Pelvic/Rectal Pain Form - How big a problem, if any, has each of the Pelvic or Rectal Pain
following been for you? Abdominal/pelvic/rectal pain.
C127378 EPIC1-Problem Bleeding EPIC1-Problem Bleeding The Expanded Prostate Cancer Index Composite Short EPIC-26 - Bleeding With
With Urination With Urination Form - How big a problem, if any, has each of the Urination
following been for you during the last 4 weeks? Bleeding
with urination.
C127385 EPIC1-Problem Bloody EPIC1-Problem Bloody The Expanded Prostate Cancer Index Composite Short EPIC-26 - Bloody Stools
Stools Stools Form - How big a problem, if any, has each of the
following been for you? Bloody stools.
C127395 EPIC1-Problem Breast EPIC1-Problem Breast The Expanded Prostate Cancer Index Composite Short EPIC-26 - Breast Tender
Tender/Enlargement Tender/Enlargement Form - How big a problem during the last 4 weeks, if any, or Enlargement
has each of the following been for you? Breast
C127398 EPIC1-Problem Change in EPIC1-Problem Change in The Expanded Prostate Cancer Index Composite Short EPIC-26 - Change in Body
Body Weight Body Weight Form - How big a problem during the last 4 weeks, if any, Weight
has each of the following been for you? Change in body
weight.
C127376 EPIC1-Problem Dripping EPIC1-Problem Dripping The Expanded Prostate Cancer Index Composite Short EPIC-26 - Dripping or
or Leaking Urine or Leaking Urine Form - How big a problem, if any, has each of the Leaking Urine
following been for you during the last 4 weeks? Dripping
or leaking urine.
C127396 EPIC1-Problem Feeling EPIC1-Problem Feeling The Expanded Prostate Cancer Index Composite Short EPIC-26 - Feeling
Depressed Depressed Form - How big a problem during the last 4 weeks, if any, Depressed
has each of the following been for you? Feeling
depressed.
C127394 EPIC1-Problem Hot EPIC1-Problem Hot The Expanded Prostate Cancer Index Composite Short EPIC-26 - Hot Flashes
Flashes Flashes Form - How big a problem during the last 4 weeks, if any,
has each of the following been for you? Hot flashes.
C127383 EPIC1-Problem Increased EPIC1-Problem Increased The Expanded Prostate Cancer Index Composite Short EPIC-26 - Increased
Freq Bowel Move Freq Bowel Move Form - How big a problem, if any, has each of the Frequency of Bowel
following been for you? Increased frequency of bowel Movements
movements.
C127397 EPIC1-Problem Lack of EPIC1-Problem Lack of The Expanded Prostate Cancer Index Composite Short EPIC-26 - Lack of Energy
Energy Energy Form - How big a problem during the last 4 weeks, if any,
has each of the following been for you? Lack of energy.
C127384 EPIC1-Problem Losing EPIC1-Problem Losing The Expanded Prostate Cancer Index Composite Short EPIC-26 - Losing Control
Control of Stools Control of Stools Form - How big a problem, if any, has each of the of Stools
following been for you? Losing control of your stools.
page 471 of 1925

C127349 EPIC1TN
Code Value
C127380 EPIC1-Problem Need to EPIC1-Problem Need to The Expanded Prostate Cancer Index Composite Short EPIC-26 - Urinate
Urinate Frequently Urinate Frequently Form - How big a problem, if any, has each of the Frequently During the
following been for you during the last 4 weeks? Need to Day
urinate frequently during the day.
C127377 EPIC1-Problem EPIC1-Problem The Expanded Prostate Cancer Index Composite Short EPIC-26 - Pain or Burning
Pain/Burning on Urination Pain/Burning on Urination Form - How big a problem, if any, has each of the on Urination
following been for you during the last 4 weeks? Pain or
burning on urination.
C127382 EPIC1-Problem Urgency EPIC1-Problem Urgency The Expanded Prostate Cancer Index Composite Short EPIC-26 - Urgency to
of Bowel Movement of Bowel Movement Form - How big a problem, if any, has each of the Have a Bowel Movement
following been for you? Urgency to have a bowel
movement.
C127379 EPIC1-Problem Weak EPIC1-Problem Weak The Expanded Prostate Cancer Index Composite Short EPIC-26 - Weak Urine
Urine Stream/Emptying Urine Stream/Emptying Form - How big a problem, if any, has each of the Stream or Incomplete
following been for you during the last 4 weeks? Weak Emptying
urine stream or incomplete emptying.
C127390 EPIC1-Quality of Your EPIC1-Quality of Your The Expanded Prostate Cancer Index Composite Short EPIC-26 - Quality of
Erections Erections Form - How would you describe the usual quality of your Erections
C127392 EPIC1-Rate Ability to EPIC1-Rate Ability to The Expanded Prostate Cancer Index Composite Short EPIC-26 - Ability to
Function Sexually Function Sexually Form - Overall, how would you rate your ability to Function Sexually
function sexually during the last 4 weeks?
C127388 EPIC1-Rate Ability to EPIC1-Rate Ability to The Expanded Prostate Cancer Index Composite Short EPIC-26 - Ability to Have
Have an Erection Have an Erection Form - How would you rate each of the following during an Erection
the last 4 weeks? Your ability to have an erection?
C127389 EPIC1-Rate Ability to EPIC1-Rate Ability to The Expanded Prostate Cancer Index Composite Short EPIC-26 - Ability to Reach
Reach Orgasm Reach Orgasm Form - How would you rate each of the following during Orgasm
the last 4 weeks? Your ability to reach orgasm (climax)?
page 472 of 1925

EPIC2TC (The Expanded Prostate Cancer Index Composite for Clinical Practice Questionnaire Test
Code)
C127352 EPIC2TC
Code Value
C127399 EPIC201 EPIC2-Overall Problem Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Overall
Urinary Function Practice - Overall, how much of a problem has your Problem Urinary Function
urinary function been for you?
C127400 EPIC202 EPIC2-Best Describes Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Best Describes
Urinary Control Practice - Which of the following best describes your Urinary Control
urinary control?
C127401 EPIC203 EPIC2-Pads or Adult Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Adult Diapers
Diapers per Day Practice - How many pads or adult diapers per day have Used per Day
you been using for urinary leakage?
C127402 EPIC204 EPIC2-Problem Urinary Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Problem
Dripping/Leakage Practice - How big a problem, if any, has urinary dripping Urinary Dripping/Leakage
or leakage been for you?
C127403 EPIC205A EPIC2-Problem Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Pain or Burning
Pain/Burning W/ Urination Practice - How big a problem, if any, has each of the With Urination
following been for you? Pain or burning with urination.
C127404 EPIC205B EPIC2-Problem Weak Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Weak Urine
Stream/Incompl Empty Practice - How big a problem, if any, has each of the Stream or Incomplete
following been for you? Weak urine stream/incomplete Bladder Emptying
bladder emptying.
C127405 EPIC205C EPIC2-Problem Need to Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Need to Urinate
Urinate Frequently Practice - How big a problem, if any, has each of the Frequently
following been for you? Need to urinate frequently.
C127406 EPIC206A EPIC2-Problem Rectal Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Rectal Pain or
Pain/Urgent Bowel Practice - How big a problem, if any, has each of the Urgency of Bowel
following been for you? Rectal pain or urgency of bowel Movements
movements.
C127407 EPIC206B EPIC2-Problem Increased Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Increased
Freq Bowel Move Practice - How big a problem, if any, has each of the Frequency of Bowel
following been for you? Increased frequency of your Movements
bowel movements.
C127408 EPIC206C EPIC2-Overall Problem Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Overall
Bowel Habits Practice - How big a problem, if any, has each of the Problems With Bowel
following been for you? Overall problems with your bowel Habits
habits.
C127409 EPIC207 EPIC2-Rate Ability to Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Rate Ability to
Reach Orgasm Practice - How would you rate your ability to reach Reach Orgasm
orgasm (climax)?
C127410 EPIC208 EPIC2-Quality of Your Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Quality of
Erections Practice - How would you describe the usual quality of Erections
your erections?
C127411 EPIC209 EPIC2-Overall Problem Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Problem Lack
Sexual Function Practice - Overall, how much of a problem has your of Sexual Function
sexual function or lack of sexual function been for you?
C127412 EPIC210A EPIC2-Problem Hot Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Hot Flashes or
Flash/Breast Tender Practice - How big a problem, if any, has each of the Breast Tenderness
following been for you? Hot flashes or breast
C127413 EPIC210B EPIC2-Problem Feeling Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Feeling
Depressed Practice - How big a problem, if any, has each of the Depressed
following been for you? Feeling depressed.
C127414 EPIC210C EPIC2-Problem Lack of Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Lack of Energy
Energy Practice - How big a problem, if any, has each of the
following been for you? Lack of energy.
C127415 EPIC211 EPIC2-Urinary Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Urinary
Incontinence Symptom Practice - Urinary incontinence symptom score. Incontinence Symptom
Score Score
C127416 EPIC212 EPIC2-Urinary Irrit/Obstr Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Urinary
Symptom Score Practice - Urinary irritation/obstruction symptom score. Irritation/Obstruction
Symptom Score
page 473 of 1925

C127352 EPIC2TC
Code Value
C127417 EPIC213 EPIC2-Bowel Symptom Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Bowel
Score Practice - Bowel symptom score. Symptom Score
C127418 EPIC214 EPIC2-Sexual Symptom Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Sexual
Score Practice - Sexual symptom score. Symptom Score
C127419 EPIC215 EPIC2-Vitality/Hormonal Expanded Prostate Cancer Index Composite for Clinical EPIC-CP -
Symptom Score Practice - Vitality/hormonal symptom score. Vitality/Hormonal
Symptom Score
C127420 EPIC216 EPIC2-Overall Prostate Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Overall Score
Cancer QOL Score Practice - Overall prostate cancer QOL score.
page 474 of 1925

EPIC2TN (The Expanded Prostate Cancer Index Composite for Clinical Practice Questionnaire Test
Name)
C127351 EPIC2TN
Code Value
C127400 EPIC2-Best Describes EPIC2-Best Describes Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Best Describes
Urinary Control Urinary Control Practice - Which of the following best describes your Urinary Control
urinary control?
C127417 EPIC2-Bowel Symptom EPIC2-Bowel Symptom Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Bowel
Score Score Practice - Bowel symptom score. Symptom Score
C127408 EPIC2-Overall Problem EPIC2-Overall Problem Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Overall
Bowel Habits Bowel Habits Practice - How big a problem, if any, has each of the Problems With Bowel
following been for you? Overall problems with your bowel Habits
habits.
C127411 EPIC2-Overall Problem EPIC2-Overall Problem Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Problem Lack
Sexual Function Sexual Function Practice - Overall, how much of a problem has your of Sexual Function
sexual function or lack of sexual function been for you?
C127399 EPIC2-Overall Problem EPIC2-Overall Problem Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Overall
Urinary Function Urinary Function Practice - Overall, how much of a problem has your Problem Urinary Function
urinary function been for you?
C127420 EPIC2-Overall Prostate EPIC2-Overall Prostate Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Overall Score
Cancer QOL Score Cancer QOL Score Practice - Overall prostate cancer QOL score.
C127401 EPIC2-Pads or Adult EPIC2-Pads or Adult Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Adult Diapers
Diapers per Day Diapers per Day Practice - How many pads or adult diapers per day have Used per Day
you been using for urinary leakage?
C127413 EPIC2-Problem Feeling EPIC2-Problem Feeling Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Feeling
Depressed Depressed Practice - How big a problem, if any, has each of the Depressed
following been for you? Feeling depressed.
C127412 EPIC2-Problem Hot EPIC2-Problem Hot Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Hot Flashes or
Flash/Breast Tender Flash/Breast Tender Practice - How big a problem, if any, has each of the Breast Tenderness
following been for you? Hot flashes or breast
C127407 EPIC2-Problem Increased EPIC2-Problem Increased Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Increased
Freq Bowel Move Freq Bowel Move Practice - How big a problem, if any, has each of the Frequency of Bowel
following been for you? Increased frequency of your Movements
bowel movements.
C127414 EPIC2-Problem Lack of EPIC2-Problem Lack of Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Lack of Energy
Energy Energy Practice - How big a problem, if any, has each of the
following been for you? Lack of energy.
C127405 EPIC2-Problem Need to EPIC2-Problem Need to Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Need to Urinate
Urinate Frequently Urinate Frequently Practice - How big a problem, if any, has each of the Frequently
following been for you? Need to urinate frequently.
C127403 EPIC2-Problem EPIC2-Problem Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Pain or Burning
Pain/Burning W/ Urination Pain/Burning W/ Urination Practice - How big a problem, if any, has each of the With Urination
following been for you? Pain or burning with urination.
C127406 EPIC2-Problem Rectal EPIC2-Problem Rectal Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Rectal Pain or
Pain/Urgent Bowel Pain/Urgent Bowel Practice - How big a problem, if any, has each of the Urgency of Bowel
following been for you? Rectal pain or urgency of bowel Movements
movements.
C127402 EPIC2-Problem Urinary EPIC2-Problem Urinary Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Problem
Dripping/Leakage Dripping/Leakage Practice - How big a problem, if any, has urinary dripping Urinary Dripping/Leakage
or leakage been for you?
C127404 EPIC2-Problem Weak EPIC2-Problem Weak Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Weak Urine
Stream/Incompl Empty Stream/Incompl Empty Practice - How big a problem, if any, has each of the Stream or Incomplete
following been for you? Weak urine stream/incomplete Bladder Emptying
bladder emptying.
C127410 EPIC2-Quality of Your EPIC2-Quality of Your Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Quality of
Erections Erections Practice - How would you describe the usual quality of Erections
your erections?
C127409 EPIC2-Rate Ability to EPIC2-Rate Ability to Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Rate Ability to
Reach Orgasm Reach Orgasm Practice - How would you rate your ability to reach Reach Orgasm
orgasm (climax)?
C127418 EPIC2-Sexual Symptom EPIC2-Sexual Symptom Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Sexual
Score Score Practice - Sexual symptom score. Symptom Score
page 475 of 1925

C127351 EPIC2TN
Code Value
C127415 EPIC2-Urinary EPIC2-Urinary Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Urinary
Incontinence Symptom Incontinence Symptom Practice - Urinary incontinence symptom score. Incontinence Symptom
Score Score Score
C127416 EPIC2-Urinary Irrit/Obstr EPIC2-Urinary Irrit/Obstr Expanded Prostate Cancer Index Composite for Clinical EPIC-CP - Urinary
Symptom Score Symptom Score Practice - Urinary irritation/obstruction symptom score. Irritation/Obstruction
Symptom Score
C127419 EPIC2-Vitality/Hormonal EPIC2-Vitality/Hormonal Expanded Prostate Cancer Index Composite for Clinical EPIC-CP -
Symptom Score Symptom Score Practice - Vitality/hormonal symptom score. Vitality/Hormonal
Symptom Score
page 476 of 1925

EPOCH (Epoch)
C99079 EPOCH
Code Value
C125938 BASELINE A period in a clinical study after eligibility has been met Baseline Epoch
and before the start of treatment, at which baseline
measurements are collected.
C102255 BLINDED TREATMENT A period in a clinical study during which subjects receive Blinded Treatment Epoch
blinded therapeutic treatment.
C123452 CONTINUATION Continuation Phase A period in a clinical study during which subjects receive Continuation Therapy
TREATMENT continuation treatment. Epoch
C99158 FOLLOW-UP A period in a clinical study during which information about Clinical Study Follow-up
the health status of an individual is obtained after study
procedures and treatments have concluded.
C123453 INDUCTION TREATMENT Induction Phase;Intensive A period in a clinical study during which subjects receive Induction Therapy Epoch
Phase induction treatment.
C16032 LONG-TERM FOLLOW-UP A period in a clinical study during which information about Long-term Follow-up
the health status of an individual is obtained long after
study procedures and treatments have concluded.
C102256 OPEN LABEL TREATMENT A period in a clinical study during which subjects receive Open Label Treatment
open label therapeutic treatment. Epoch
C98779 RUN-IN A period in a clinical study that occurs before the Run-in Period
commencement of the primary clinical study
investigation, during which subjects may be assessed for
suitability in the clinical study, withdrawn from existing
therapy, trained in study methodology or evaluated for
any other protocol-specified reason.
C48262 SCREENING A period in a clinical study during which subjects are Trial Screening
evaluated for participation in the study.
C101526 TREATMENT A period in a clinical study during which subjects receive Treatment Epoch
investigational product.
C42872 WASHOUT A period of time during a clinical study when a participant Washout Period
is taken off of a study drug or other medication in order
to eliminate the effects of the treatment.
page 477 of 1925

EQ5D01TC (European Quality of Life Five Dimension Three Level Scale Questionnaire Test Code)
C100136 EQ5D01TC
Code Value
C100392 EQ5D0101 EQ5D01-Mobility European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Mobility
- Indicate which statements best describe your own
health state today: Mobility.
C100393 EQ5D0102 EQ5D01-Self-Care European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Self-Care
health state today: Self-care.
C100394 EQ5D0103 EQ5D01-Usual Activities European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Usual
- Indicate which statements best describe your own Activities
health state today: Usual activities.
C100395 EQ5D0104 EQ5D01-Pain/Discomfort European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Pain or
- Indicate which statements best describe your own Discomfort
health state today: Pain/discomfort.
C100396 EQ5D0105 EQ5D01- European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Anxiety or
Anxiety/Depression - Indicate which statements best describe your own Depression
health state today: Anxiety/depression.
C100397 EQ5D0106 EQ5D01-EQ VAS Score European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - EQ VAS Score
- Indicate on this scale how good or bad your own health
is today, in your opinion.
page 478 of 1925

EQ5D01TN (European Quality of Life Five Dimension Three Level Scale Questionnaire Test Name)
C100135 EQ5D01TN
Code Value
C100396 EQ5D01- EQ5D01- European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Anxiety or
Anxiety/Depression Anxiety/Depression - Indicate which statements best describe your own Depression
health state today: Anxiety/depression.
C100397 EQ5D01-EQ VAS Score EQ5D01-EQ VAS Score European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - EQ VAS Score
- Indicate on this scale how good or bad your own health
is today, in your opinion.
C100392 EQ5D01-Mobility EQ5D01-Mobility European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Mobility
health state today: Mobility.
C100395 EQ5D01-Pain/Discomfort EQ5D01-Pain/Discomfort European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Pain or
- Indicate which statements best describe your own Discomfort
health state today: Pain/discomfort.
C100393 EQ5D01-Self-Care EQ5D01-Self-Care European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Self-Care
health state today: Self-care.
C100394 EQ5D01-Usual Activities EQ5D01-Usual Activities European Quality of Life Five Dimension Three Level Scale EQ-5D-3L - Usual
- Indicate which statements best describe your own Activities
health state today: Usual activities.
page 479 of 1925

EQ5D02TC (European Quality of Life Five Dimension Five Level Scale Questionnaire Test Code)
C101817 EQ5D02TC
Code Value
C102067 EQ5D0201 EQ5D02-Mobility European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Mobility
Check the one box that best describes your health today:
Mobility.
C102068 EQ5D0202 EQ5D02-Self-Care European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Self-Care
Self-care.
C102069 EQ5D0203 EQ5D02-Usual Activities European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Usual
Check the one box that best describes your health today: Activities
Usual activities.
C102070 EQ5D0204 EQ5D02-Pain/Discomfort European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Pain or
Check the one box that best describes your health today: Discomfort
Pain/discomfort.
C102071 EQ5D0205 EQ5D02- European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Anxiety or
Anxiety/Depression Check the one box that best describes your health today: Depression
Anxiety/depression.
C102072 EQ5D0206 EQ5D02-EQ VAS Score European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - EQ VAS Score
Indicate how your health is today.
page 480 of 1925

EQ5D02TN (European Quality of Life Five Dimension Five Level Scale Questionnaire Test Name)
C101818 EQ5D02TN
Code Value
C102071 EQ5D02- EQ5D02- European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Anxiety or
Anxiety/Depression Anxiety/Depression Check the one box that best describes your health today: Depression
Anxiety/depression.
C102072 EQ5D02-EQ VAS Score EQ5D02-EQ VAS Score European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - EQ VAS Score
Indicate how your health is today.
C102067 EQ5D02-Mobility EQ5D02-Mobility European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Mobility
Mobility.
C102070 EQ5D02-Pain/Discomfort EQ5D02-Pain/Discomfort European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Pain or
Check the one box that best describes your health today: Discomfort
Pain/discomfort.
C102068 EQ5D02-Self-Care EQ5D02-Self-Care European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Self-Care
Self-care.
C102069 EQ5D02-Usual Activities EQ5D02-Usual Activities European Quality of Life Five Dimension Five Level Scale - EQ-5D-5L - Usual
Check the one box that best describes your health today: Activities
Usual activities.
page 481 of 1925

ESRSA1TC (Extrapyramidal Symptom Rating Scale-Abbreviated Clinical Classification Test Code)
C117991 ESRSA1TC
Code Value
C118079 ESRSA101 ESRSA1-Rigidity: Upper Limbs Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Rigidity: Upper
Parkinsonism-Rigidity: Upper limbs. Limbs
C118080 ESRSA102 ESRSA1-Rigidity: Lower Limbs Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Rigidity: Lower
Parkinsonism-Rigidity: Lower limbs. Limbs
C118081 ESRSA103 ESRSA1-Rigidity: Neck Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Rigidity: Neck
Parkinsonism-Rigidity: Neck.
C118082 ESRSA104 ESRSA1-Tremor: Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Tremor:

Face/Jaw/Chin/Lips/Head Parkinsonism-Tremor: Face, jaw/chin, lips, head. Face/Jaw/Chin/Lips/Head
C118083 ESRSA105 ESRSA1-Tremor: Upper Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Tremor: Upper
Limbs/Hands Parkinsonism-Tremor: Upper limbs/hands. Limbs/Hands
C118084 ESRSA106 ESRSA1-Tremor: Lower Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Tremor: Lower
Limbs/Feet Parkinsonism-Tremor: Lower limbs/feet. Limbs/Feet
C118085 ESRSA107 ESRSA1-Reduced Facial Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Reduced Facial
Expression/Speech Parkinsonism-Reduced facial expression/speech. Expression/Speech
C118086 ESRSA108 ESRSA1-Impaired Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Impaired

Gait/Posture Parkinsonism-Impaired gait/posture. Gait/Posture
C118087 ESRSA109 ESRSA1-Postural Instability Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Postural
Parkinsonism-Postural instability. Instability
C118088 ESRSA110 ESRSA1- Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A -

Bradykinesia/Hypokinesia Parkinsonism-Bradykinesia/hypokinesia. Bradykinesia/Hypokinesia
C118089 ESRSA111 ESRSA1-Dystonia: Tongue Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Dystonia:
Dystonia: Tongue. Tongue
C118090 ESRSA112 ESRSA1-Dystonia: Jaw Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Dystonia: Jaw
Dystonia: Jaw.
C118091 ESRSA113 ESRSA1-Dystonia: Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Dystonia:

Eyes/Face/Larynx Dystonia: Eyes, upper face, lower face, larynx. Eyes/Upper and Lower
Face/Larynx

Shoulder/Up Limb/Hand Dystonia: Shoulders, upper limbs, hands. Shoulder/Upper
Limbs/Hands
C118093 ESRSA115 ESRSA1-Dystonia: Hips/Lower Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Dystonia:
Limbs/Feet Dystonia: Hips, lower limbs, feet. Hips/Lower Limbs/Feet

Trunk/Neck Dystonia: Trunk, neck. Trunk/Neck
C118095 ESRSA117 ESRSA1-Dyskinesia: Tongue Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Dyskinesia:
Dyskinesia: Tongue. Tongue
C118096 ESRSA118 ESRSA1-Dyskinesia: Jaw Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Dyskinesia: Jaw
Dyskinesia: Jaw.
C118097 ESRSA119 ESRSA1-Dyskinesia: Eyes/Up Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Dyskinesia:
Face/Low Face Dyskinesia: Eyes, upper face, lower face. Eyes/Upper Face/Lower
Face
C118098 ESRSA120 ESRSA1-Dyskinesia: Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Dyskinesia:

Shoulder/Up Limb/Hand Dyskinesia: Shoulders, upper limbs, hands. Shoulder/Upper
Limbs/Hands

Hips/Lower Limbs/Feet Dyskinesia: Hips, lower limbs, feet. Hips/Lower Limbs/Feet

Trunk/Neck Dyskinesia: Trunk, neck. Trunk/Neck
C118101 ESRSA123 ESRSA1-Akathisia: Subjective Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Akathisia:
Akathisia: Subjective. Subjective
C118102 ESRSA124 ESRSA1-Akathisia: Objective Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - Akathisia:
Akathisia: Objective. Objective
C118103 ESRSA125 ESRSA1-CGI-S Parkinsonism Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - CGI-S
Clinical Global Impression (CGI-S): Parkinsonism. Parkinsonism
page 482 of 1925

C117991 ESRSA1TC
Code Value
C118104 ESRSA126 ESRSA1-CGI-S Dystonia Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - CGI-S Dystonia
Clinical Global Impression (CGI-S): Dystonia.
C118105 ESRSA127 ESRSA1-CGI-S Dyskinesia Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - CGI-S
Clinical Global Impression (CGI-S): Dyskinesia. Dyskinesia
C118106 ESRSA128 ESRSA1-CGI-S Akathisia Extrapyramidal Symptom Rating Scale-Abbreviated - ESRS-A - CGI-S Akathisia
Clinical Global Impression (CGI-S): Akathisia.
page 483 of 1925

ESRSA1TN (Extrapyramidal Symptom Rating Scale-Abbreviated Clinical Classification Test Name)
C117990 ESRSA1TN
Code
C118102 ESRSA1-Akathisia: Objective ESRSA1-Akathisia: Objective Extrapyramidal Symptom Rating Scale- ESRS-A - Akathisia:
Abbreviated - Akathisia: Objective. Objective
C118101 ESRSA1-Akathisia: Subjective ESRSA1-Akathisia: Subjective Extrapyramidal Symptom Rating Scale- ESRS-A - Akathisia:
Abbreviated - Akathisia: Subjective. Subjective
C118088 ESRSA1- ESRSA1- Extrapyramidal Symptom Rating Scale- ESRS-A -

Bradykinesia/Hypokinesia Bradykinesia/Hypokinesia Abbreviated - Parkinsonism- Bradykinesia/Hypokinesia
Bradykinesia/hypokinesia.
C118106 ESRSA1-CGI-S Akathisia ESRSA1-CGI-S Akathisia Extrapyramidal Symptom Rating Scale- ESRS-A - CGI-S Akathisia
Abbreviated - Clinical Global Impression (CGI-S):
Akathisia.
C118105 ESRSA1-CGI-S Dyskinesia ESRSA1-CGI-S Dyskinesia Extrapyramidal Symptom Rating Scale- ESRS-A - CGI-S
Abbreviated - Clinical Global Impression (CGI-S): Dyskinesia
Dyskinesia.
C118104 ESRSA1-CGI-S Dystonia ESRSA1-CGI-S Dystonia Extrapyramidal Symptom Rating Scale- ESRS-A - CGI-S Dystonia
Abbreviated - Clinical Global Impression (CGI-S):
Dystonia.
C118103 ESRSA1-CGI-S Parkinsonism ESRSA1-CGI-S Parkinsonism Extrapyramidal Symptom Rating Scale- ESRS-A - CGI-S
Abbreviated - Clinical Global Impression (CGI-S): Parkinsonism
Parkinsonism.
C118097 ESRSA1-Dyskinesia: Eyes/Up ESRSA1-Dyskinesia: Eyes/Up Extrapyramidal Symptom Rating Scale- ESRS-A - Dyskinesia:
Face/Low Face Face/Low Face Abbreviated - Dyskinesia: Eyes, upper face, Eyes/Upper Face/Lower
lower face. Face
C118099 ESRSA1-Dyskinesia: ESRSA1-Dyskinesia: Extrapyramidal Symptom Rating Scale- ESRS-A - Dyskinesia:

Hips/Lower Limbs/Feet Hips/Lower Limbs/Feet Abbreviated - Dyskinesia: Hips, lower limbs, feet. Hips/Lower Limbs/Feet
C118096 ESRSA1-Dyskinesia: Jaw ESRSA1-Dyskinesia: Jaw Extrapyramidal Symptom Rating Scale- ESRS-A - Dyskinesia: Jaw
Abbreviated - Dyskinesia: Jaw.

Shoulder/Up Limb/Hand Shoulder/Up Limb/Hand Abbreviated - Dyskinesia: Shoulders, upper Shoulder/Upper
limbs, hands. Limbs/Hands
C118095 ESRSA1-Dyskinesia: Tongue ESRSA1-Dyskinesia: Tongue Extrapyramidal Symptom Rating Scale- ESRS-A - Dyskinesia:
Abbreviated - Dyskinesia: Tongue. Tongue

Trunk/Neck Trunk/Neck Abbreviated - Dyskinesia: Trunk, neck. Trunk/Neck
C118091 ESRSA1-Dystonia: ESRSA1-Dystonia: Extrapyramidal Symptom Rating Scale- ESRS-A - Dystonia:

Eyes/Face/Larynx Eyes/Face/Larynx Abbreviated - Dystonia: Eyes, upper face, lower Eyes/Upper and Lower
face, larynx. Face/Larynx
C118093 ESRSA1-Dystonia: Hips/Lower ESRSA1-Dystonia: Hips/Lower Extrapyramidal Symptom Rating Scale- ESRS-A - Dystonia:
Limbs/Feet Limbs/Feet Abbreviated - Dystonia: Hips, lower limbs, feet. Hips/Lower Limbs/Feet
C118090 ESRSA1-Dystonia: Jaw ESRSA1-Dystonia: Jaw Extrapyramidal Symptom Rating Scale- ESRS-A - Dystonia: Jaw
Abbreviated - Dystonia: Jaw.

Shoulder/Up Limb/Hand Shoulder/Up Limb/Hand Abbreviated - Dystonia: Shoulders, upper limbs, Shoulder/Upper
hands. Limbs/Hands
C118089 ESRSA1-Dystonia: Tongue ESRSA1-Dystonia: Tongue Extrapyramidal Symptom Rating Scale- ESRS-A - Dystonia:
Abbreviated - Dystonia: Tongue. Tongue

Trunk/Neck Trunk/Neck Abbreviated - Dystonia: Trunk, neck. Trunk/Neck
C118086 ESRSA1-Impaired ESRSA1-Impaired Extrapyramidal Symptom Rating Scale- ESRS-A - Impaired

Gait/Posture Gait/Posture Abbreviated - Parkinsonism-Impaired Gait/Posture
gait/posture.
C118087 ESRSA1-Postural Instability ESRSA1-Postural Instability Extrapyramidal Symptom Rating Scale- ESRS-A - Postural
Abbreviated - Parkinsonism-Postural instability. Instability
C118085 ESRSA1-Reduced Facial ESRSA1-Reduced Facial Extrapyramidal Symptom Rating Scale- ESRS-A - Reduced Facial
Expression/Speech Expression/Speech Abbreviated - Parkinsonism-Reduced facial Expression/Speech
expression/speech.
page 484 of 1925

C117990 ESRSA1TN
Code
C118080 ESRSA1-Rigidity: Lower Limbs ESRSA1-Rigidity: Lower Limbs Extrapyramidal Symptom Rating Scale- ESRS-A - Rigidity: Lower
Abbreviated - Parkinsonism-Rigidity: Lower Limbs
limbs.
C118081 ESRSA1-Rigidity: Neck ESRSA1-Rigidity: Neck Extrapyramidal Symptom Rating Scale- ESRS-A - Rigidity: Neck
Abbreviated - Parkinsonism-Rigidity: Neck.
C118079 ESRSA1-Rigidity: Upper Limbs ESRSA1-Rigidity: Upper Limbs Extrapyramidal Symptom Rating Scale- ESRS-A - Rigidity: Upper
Abbreviated - Parkinsonism-Rigidity: Upper Limbs
limbs.
C118082 ESRSA1-Tremor: ESRSA1-Tremor: Extrapyramidal Symptom Rating Scale- ESRS-A - Tremor:

Face/Jaw/Chin/Lips/Head Face/Jaw/Chin/Lips/Head Abbreviated - Parkinsonism-Tremor: Face, Face/Jaw/Chin/Lips/Head
jaw/chin, lips, head.
C118084 ESRSA1-Tremor: Lower ESRSA1-Tremor: Lower Extrapyramidal Symptom Rating Scale- ESRS-A - Tremor: Lower
Limbs/Feet Limbs/Feet Abbreviated - Parkinsonism-Tremor: Lower Limbs/Feet
limbs/feet.
C118083 ESRSA1-Tremor: Upper ESRSA1-Tremor: Upper Extrapyramidal Symptom Rating Scale- ESRS-A - Tremor: Upper
Limbs/Hands Limbs/Hands Abbreviated - Parkinsonism-Tremor: Upper Limbs/Hands
limbs/hands.
page 485 of 1925

ESS01TC (Epworth Sleepiness Scale Questionnaire Test Code)
C103463 ESS01TC
Code Value
C103536 ESS0101 ESS01-Sitting and Epworth Sleepiness Scale - Sitting and reading. ESS - Sitting and Reading
Reading
C103537 ESS0102 ESS01-Watching TV Epworth Sleepiness Scale - Watching TV. ESS - Watching TV
C103538 ESS0103 ESS01-Sitting Inactive in Epworth Sleepiness Scale - Sitting, inactive in a public ESS - Sitting, Inactive in
a Public Place place (e.g. a theatre or a meeting). a Public Place
C103539 ESS0104 ESS01-Passenger for Epworth Sleepiness Scale - As a passenger in a car for an ESS - As a Passenger in a
Hour Without Break hour without a break. Car for an Hour Without a
Break
C103540 ESS0105 ESS01-Lying Down to Epworth Sleepiness Scale - Lying down to rest in the ESS - Lying Down to Rest
Rest In Afternoon afternoon when circumstances permit. in the Afternoon When
Circumstances Permit
C103541 ESS0106 ESS01-Sitting and Talking Epworth Sleepiness Scale - Sitting and talking to ESS - Sitting and Talking
to Someone someone. to Someone
C103542 ESS0107 ESS01-Sitting Quietly Epworth Sleepiness Scale - Sitting quietly after a lunch ESS - Sitting Quietly After
After Lunch without alcohol. a Lunch without Alcohol
C103543 ESS0108 ESS01-In Car Stopped Epworth Sleepiness Scale - In a car, while stopped for a ESS - In a car, While
Few Minutes Traffic few minutes in the traffic. Stopped for a Few
Minutes in the Traffic
page 486 of 1925

ESS01TN (Epworth Sleepiness Scale Questionnaire Test Name)
C103462 ESS01TN
Code Value
C103543 ESS01-In Car Stopped ESS01-In Car Stopped Epworth Sleepiness Scale - In a car, while stopped for a ESS - In a car, While
Few Minutes Traffic Few Minutes Traffic few minutes in the traffic. Stopped for a Few
Minutes in the Traffic
C103540 ESS01-Lying Down to ESS01-Lying Down to Epworth Sleepiness Scale - Lying down to rest in the ESS - Lying Down to Rest
Rest In Afternoon Rest In Afternoon afternoon when circumstances permit. in the Afternoon When
Circumstances Permit
C103539 ESS01-Passenger for ESS01-Passenger for Epworth Sleepiness Scale - As a passenger in a car for an ESS - As a Passenger in a
Hour Without Break Hour Without Break hour without a break. Car for an Hour Without a
Break
C103536 ESS01-Sitting and ESS01-Sitting and Epworth Sleepiness Scale - Sitting and reading. ESS - Sitting and Reading
Reading Reading
C103541 ESS01-Sitting and Talking ESS01-Sitting and Talking Epworth Sleepiness Scale - Sitting and talking to ESS - Sitting and Talking
to Someone to Someone someone. to Someone
C103538 ESS01-Sitting Inactive in ESS01-Sitting Inactive in Epworth Sleepiness Scale - Sitting, inactive in a public ESS - Sitting, Inactive in
a Public Place a Public Place place (e.g. a theatre or a meeting). a Public Place
C103542 ESS01-Sitting Quietly ESS01-Sitting Quietly Epworth Sleepiness Scale - Sitting quietly after a lunch ESS - Sitting Quietly After
After Lunch After Lunch without alcohol. a Lunch without Alcohol
C103537 ESS01-Watching TV ESS01-Watching TV Epworth Sleepiness Scale - Watching TV. ESS - Watching TV
page 487 of 1925

ETHNIC (Ethnic Group)
C66790 ETHNIC
Code Value
C17459 HISPANIC OR LATINO A person of Mexican, Puerto Rican, Cuban, Central or Hispanic or Latino
South American or other Spanish culture or origin,
regardless of race. (NCI)
C41222 NOT HISPANIC OR A person not of Cuban, Mexican, Puerto Rican, South or Not Hispanic or Latino
LATINO Central American, or other Spanish culture or origin,
regardless of race. An arbitrary ethnic classification. (NCI)
C43234 NOT REPORTED Not reported Not provided or available. Not Reported
page 488 of 1925

ETHNICC (Ethnicity As Collected)
C128690 ETHNICC
Code Value
C17950 ASHKENAZI JEW A person of Ashkenazi Jewish descent. Ashkenazi Jew
C67118 CENTRAL AMERICAN A person of Central American descent. Central American
C107608 CUBAN A person of Cuban descent. Cuban
C67115 CUBAN AMERICAN A person of Cuban and American descent. Cuban or Cuban American
C17459 HISPANIC OR LATINO A person of Mexican, Puerto Rican, Cuban, Central or Hispanic or Latino
South American or other Spanish culture or origin,
regardless of race. (NCI)
C126531 LATIN AMERICAN A person of Latin American descent. Latin American
C67113 MEXICAN A person of Mexican descent. Mexican
C67114 MEXICAN AMERICAN A person of Mexican and American descent. Mexican American
C41222 NOT HISPANIC OR A person not of Cuban, Mexican, Puerto Rican, South or Not Hispanic or Latino
LATINO Central American, or other Spanish culture or origin,
regardless of race. An arbitrary ethnic classification. (NCI)
C67112 PUERTO RICAN A person of Puerto Rican descent. Puerto Rican
C103283 SEPHARDIC JEW A person of Sephardic Jewish descent. Sephardic Jew
C126532 SOUTH AMERICAN A person of South American descent. South American
C67120 SPANISH A person from Spain or of Spanish descent. Spanish
page 489 of 1925

EVAL (Evaluator)
C78735 EVAL
Code Value
C78726 ADJUDICATION An external committee whose purpose is to evaluate Adjudication Committee

COMMITTEE study data and decide whether a study endpoint or other
criterion has been met. (NCI)
C96561 ADJUDICATOR An individual that presides over and arbitrates between Adjudicator
individuals or organizations.
C17445 CAREGIVER Caregiver The primary person in charge of the care of a patient, Caregiver
usually a family member or a designated health care
professional. (NCI)
C150886 CHILD A biological or non-biological first generation offspring, Child Relation

including but not limited to biological children (including
those born outside of marriage), adopted children, step
children, and foster children. (NCI)
C25465 CLINICAL RESEARCH Research Associate A person who is employed by a study sponsor or by a Clinical Research
ASSOCIATE contract research organization (CRO), operates Associate
independently from the clinical study site and functions as
a monitor, and/or auditor, and/or a project director within
a particular trial or institution. (NCI)
C51811 CLINICAL RESEARCH CRC A person to whom a clinical investigator delegates routine Clinical Coordinator
COORDINATOR administrative requirements of a protocol. The duties and
responsibilities of a clinical research coordinator may vary
across different infrastructures. Generally, the coordinator
manages the subject's clinical trial participation and
provides a vital linkage between the subject, the
investigator, and the sponsor. (NCI)
C70793 CLINICAL STUDY Clinical Study An entity that is responsible for the initiation, Clinical Study Sponsor
SPONSOR Sponsor;Sponsor;Study management, and/or financing of a clinical study.
Sponsor
C53262 DOMESTIC PARTNER Domestic Partner Person declares that a domestic partnership relationship Domestic Partnership
exists. (HL7)
C41256 FAMILY MEMBER Family Member Any of the individuals who are descended from a common Family Member
progenitor, related by marriage or other legal tie.
C72884 FRIEND A person whom an individual knows, likes, and trusts. Friend
(NCI)
C51828 GUARDIAN An individual who is authorized under applicable State or Guardian

local law to consent on behalf of a child or incapable
person to general medical care including participation in
clinical research. (NCI)
C53287 HEALTH CARE A person qualified to be engaged in activity directed at Health Care Professional
PROFESSIONAL preservation of mental and physical health by diseases
prevention and treatment as a source of livelihood. (NCI)
C78720 INDEPENDENT An individual qualified to perform an evaluation who is Independent Rater

ASSESSOR masked from a subject's data in order to minimize bias or
maximize consistency and quality. (NCI)
C63759 INTERVIEWER The person who manages an interview and asks the Interviewer
questions.
C25936 INVESTIGATOR A person responsible for the conduct of the clinical trial at Investigator
a trial site. If a trial is conducted by a team of individuals
at the trial site, the investigator is the responsible leader
of the team and may be called the principle investigator.
C42709 PARENT A mother or a father. Parent
C119264 PROXY A type of directive that gives a person the authority to Proxy
make decisions for or provide responses on behalf of
another individual.
C25204 SIBLING A person's brother or sister. Sibling
C119265 SIGNIFICANT OTHER A gender-neutral term for a person's partner in an Significant Other
intimate or romantic relationship without disclosing or
presuming marital status or sexual orientation.
C62649 SPOUSE Spouse A person's partner in marriage. (NCI) Spouse
page 490 of 1925

C78735 EVAL
Code Value
C41189 STUDY SUBJECT An individual who is observed, analyzed, examined, Study Subject
investigated, experimented upon, or/and treated in the
course of a particular study.
C68608 VENDOR A person or agency that promotes or exchanges goods or Vendor

services for money. (NCI)
page 491 of 1925

EVDRETRT (Supporting Evidence for Re-Treatment)
C102579 EVDRETRT
Code Value
C102602 BACTERIOLOGICAL Objective evidence of bacterial infection perceptible to the Bacteriological Finding
FINDING examiner by laboratory procedure.
C100104 CLINICAL FINDING Clinical Signs Objective evidence of disease perceptible to the examiner Sign or Symptom
(sign) and subjective evidence of disease perceived by
the subject (symptom).
C35869 RADIOLOGIC FINDING Objective evidence of disease perceptible to the examiner Radiologic Finding
by radiological procedure.
page 492 of 1925

EXACT1TC (Exacerbations of Chronic Pulmonary Disease Tool Patient-Reported Outcome Questionnaire
Test Code)
C123653 EXACT1TC
Code Value
C123669 EXACT101 EXACT1-Chest Feel Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Chest Feel
Congested Reported Outcome - Did your chest feel congested today? Congested
C123670 EXACT102 EXACT1-How Often Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - How Often
Cough Reported Outcome - How often did you cough today? Cough Today
C123671 EXACT103 EXACT1-Bring Up Mucus Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Bring Up Mucus
When Coughing Reported Outcome - How much mucus (phlegm) did you When Coughing
bring up when coughing today?
C123672 EXACT104 EXACT1-Difficult to Bring Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Difficult to Bring
Up Mucus Reported Outcome - How difficult was it to bring up Up Mucus
mucus (phlegm) today?
C123673 EXACT105 EXACT1-Chest Discomfort Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Have Chest
Reported Outcome - Did you have chest discomfort Discomfort
today?
C123674 EXACT106 EXACT1-Chest Feel Tight Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Chest Feel Tight
Reported Outcome - Did your chest feel tight today?
C123675 EXACT107 EXACT1-Breathless Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Were You
Reported Outcome - Were you breathless today? Breathless
C123676 EXACT108 EXACT1-Describe How Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Describe How
Breathless Reported Outcome - Describe how breathless you were Breathless
today.
C123677 EXACT109 EXACT1-Short Breath Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Short of Breath
Personal Care Reported Outcome - Were you short of breath today When Performing Usual
when performing your usual personal care activities like Personal Care
washing or dressing?
Indoor Activities Reported Outcome - Were you short of breath today When Performing Usual
when performing your usual indoor activities like cleaning Indoor Activities
or household work?
Outside Activities Reported Outcome - Were you short of breath today When Performing Usual
when performing your usual activities outside the home Activities Outside
such as yard work or errands?
C123680 EXACT112 EXACT1-Tired or Weak Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Tired or Weak
Reported Outcome - Were you tired or weak today?
C123681 EXACT113 EXACT1-Night Sleep Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Night Sleep
Disturbed Reported Outcome - Last night, was your sleep Disturbed
disturbed?
C123682 EXACT114 EXACT1-Worried About Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Worried About
Lung Problems Reported Outcome - How scared or worried were you Lung Problems
about your lung problems today?
page 493 of 1925

EXACT1TN (Exacerbations of Chronic Pulmonary Disease Tool Patient-Reported Outcome
C123652 EXACT1TN
Code Value
C123675 EXACT1-Breathless EXACT1-Breathless Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Were You
Reported Outcome - Were you breathless today? Breathless
C123671 EXACT1-Bring Up Mucus EXACT1-Bring Up Mucus Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Bring Up Mucus
When Coughing When Coughing Reported Outcome - How much mucus (phlegm) did you When Coughing
bring up when coughing today?
C123673 EXACT1-Chest Discomfort EXACT1-Chest Discomfort Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Have Chest
Reported Outcome - Did you have chest discomfort Discomfort
today?
C123669 EXACT1-Chest Feel EXACT1-Chest Feel Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Chest Feel
Congested Congested Reported Outcome - Did your chest feel congested today? Congested
C123674 EXACT1-Chest Feel Tight EXACT1-Chest Feel Tight Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Chest Feel Tight
Reported Outcome - Did your chest feel tight today?
C123676 EXACT1-Describe How EXACT1-Describe How Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Describe How
Breathless Breathless Reported Outcome - Describe how breathless you were Breathless
today.
C123672 EXACT1-Difficult to Bring EXACT1-Difficult to Bring Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Difficult to Bring
Up Mucus Up Mucus Reported Outcome - How difficult was it to bring up Up Mucus
mucus (phlegm) today?
C123670 EXACT1-How Often EXACT1-How Often Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - How Often
Cough Cough Reported Outcome - How often did you cough today? Cough Today
C123681 EXACT1-Night Sleep EXACT1-Night Sleep Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Night Sleep
Disturbed Disturbed Reported Outcome - Last night, was your sleep Disturbed
disturbed?
C123678 EXACT1-Short Breath EXACT1-Short Breath Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Short of Breath
Indoor Activities Indoor Activities Reported Outcome - Were you short of breath today When Performing Usual
when performing your usual indoor activities like cleaning Indoor Activities
or household work?
Outside Activities Outside Activities Reported Outcome - Were you short of breath today When Performing Usual
when performing your usual activities outside the home Activities Outside
such as yard work or errands?
Personal Care Personal Care Reported Outcome - Were you short of breath today When Performing Usual
when performing your usual personal care activities like Personal Care
washing or dressing?
C123680 EXACT1-Tired or Weak EXACT1-Tired or Weak Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Tired or Weak
Reported Outcome - Were you tired or weak today?
C123682 EXACT1-Worried About EXACT1-Worried About Exacerbations of Chronic Pulmonary Disease Tool Patient- EXACT - Worried About
Lung Problems Lung Problems Reported Outcome - How scared or worried were you Lung Problems
about your lung problems today?
page 494 of 1925

FAC001TC (The Functional Assessment of Cancer Therapy-General Version 4 Questionnaire Test Code)
C127354 FAC001TC
Code Value
C127421 FAC00101 FAC001-I Have a Lack of Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
Energy Version 4 - Physical Well-Being: I have a lack of energy. Have a Lack of Energy
C127422 FAC00102 FAC001-I Have Nausea Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
Version 4 - Physical Well-Being: I have nausea. Have Nausea
C127423 FAC00103 FAC001-Trouble Meeting Functional Assessment of Cancer Therapy-General FACT-G Version 4 -
Needs of Family Version 4 - Physical Well-Being: Because of my physical Trouble Meeting Needs of
condition, I have trouble meeting the needs of my family. Family
C127424 FAC00104 FAC001-I Have Pain Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
Version 4 - Physical Well-Being: I have pain. have pain
C127425 FAC00105 FAC001-Bothered by Functional Assessment of Cancer Therapy-General FACT-G Version 4 -

Treatment Side Effect Version 4 - Physical Well-Being: I am bothered by side Bothered by Treatment
effects of treatment. Side Effect
C127426 FAC00106 FAC001-I Feel Ill Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
Version 4 - Physical Well-Being: I feel ill. Ill
C127427 FAC00107 FAC001-I Am Forced to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
Spend Time in Bed Version 4 - Physical Well-Being: I am forced to spend Forced to Spend Time in
time in bed. Bed
C127428 FAC00108 FAC001-I Feel Close to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
My Friends Version 4 - Social/Family Well-Being: I feel close to my Close to My Friends
friends.
C127429 FAC00109 FAC001-Get Emotional Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Get
Support From Family Version 4 - Social/Family Well-Being: I get emotional Emotional Support From
support from my family. My Family
C127430 FAC00110 FAC001-I Get Support Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Get
From My Friends Version 4 - Social/Family Well-Being: I get support from Support From My Friends
my friends.
C127431 FAC00111 FAC001-My Family Has Functional Assessment of Cancer Therapy-General FACT-G Version 4 - My
Accepted My Illness Version 4 - Social/Family Well-Being: My family has Family Has Accepted My
accepted my illness. Illness
C127432 FAC00112 FAC001-Satisfied Functional Assessment of Cancer Therapy-General FACT-G Version 4 -

Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With Family
family communication about my illness. Communication
C127433 FAC00113 FAC001-I Feel Close to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
My Partner Version 4 - Social/Family Well-Being: I feel close to my Close to My Partner
partner (or the person who is my main support).
C127434 FAC00114 FAC001-I Am Satisfied Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
With My Sex Life Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With My Sex Life
my sex life.
C127435 FAC00115 FAC001-I Feel Sad Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
Version 4 - Emotional Well-Being: I feel sad. Sad
C127436 FAC00116 FAC001-Satisfied With Functional Assessment of Cancer Therapy-General FACT-G Version 4 -
How I Am Coping Version 4 - Emotional Well-Being: I am satisfied with how Satisfied With How I Am
I am coping with my illness. Coping With Illness
C127437 FAC00117 FAC001-Losing Hope Functional Assessment of Cancer Therapy-General FACT-G Version 4 -
Against Illness Version 4 - Emotional Well-Being: I am losing hope in the Losing Hope Against
fight against my illness. Illness
C127438 FAC00118 FAC001-I Feel Nervous Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
Version 4 - Emotional Well-Being: I feel nervous. Nervous
C127439 FAC00119 FAC001-I Worry About Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
Dying Version 4 - Emotional Well-Being: I worry about dying. Worry About Dying
C127440 FAC00120 FAC001-Worry My Functional Assessment of Cancer Therapy-General FACT-G Version 4 - Worry
Condition Will Get Worse Version 4 - Emotional Well-Being: I worry that my My Condition Will Get
condition will get worse. Worse
C127441 FAC00121 FAC001-I Am Able to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
Work Version 4 - Functional Well-Being: I am able to work Able to Work
(include work at home).
page 495 of 1925

C127354 FAC001TC
Code Value
C127442 FAC00122 FAC001-My Work Is Functional Assessment of Cancer Therapy-General FACT-G Version 4 - My
Fulfilling Version 4 - Functional Well-Being: My work (include work Work Is Fulfilling
at home) is fulfilling.
C127443 FAC00123 FAC001-I Am Able to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
Enjoy Life Version 4 - Functional Well-Being: I am able to enjoy life. Able to Enjoy Life
C127444 FAC00124 FAC001-I Have Accepted Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
My Illness Version 4 - Functional Well-Being: I have accepted my Have Accepted My Illness
illness.
C127445 FAC00125 FAC001-I Am Sleeping Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
Well Version 4 - Functional Well-Being: I am sleeping well. Sleeping Well
C127446 FAC00126 FAC001-Enjoy Things I Functional Assessment of Cancer Therapy-General FACT-G Version 4 - Enjoy
Usually Do for Fun Version 4 - Functional Well-Being: I am enjoying the Things I Usually Do for
things I usually do for fun. Fun
C127447 FAC00127 FAC001-Content With Functional Assessment of Cancer Therapy-General FACT-G Version 4 -
Quality of My Life Version 4 - Functional Well-Being: I am content with the Content With Quality of
quality of my life right now. My Life
page 496 of 1925

FAC001TN (The Functional Assessment of Cancer Therapy-General Version 4 Questionnaire Test
Name)
C127353 FAC001TN
Code Value
C127425 FAC001-Bothered by FAC001-Bothered by Functional Assessment of Cancer Therapy-General FACT-G Version 4 -

Treatment Side Effect Treatment Side Effect Version 4 - Physical Well-Being: I am bothered by side Bothered by Treatment
C127447 FAC001-Content With FAC001-Content With Functional Assessment of Cancer Therapy-General FACT-G Version 4 -
Quality of My Life Quality of My Life Version 4 - Functional Well-Being: I am content with the Content With Quality of
C127446 FAC001-Enjoy Things I FAC001-Enjoy Things I Functional Assessment of Cancer Therapy-General FACT-G Version 4 - Enjoy
Usually Do for Fun Usually Do for Fun Version 4 - Functional Well-Being: I am enjoying the Things I Usually Do for
C127429 FAC001-Get Emotional FAC001-Get Emotional Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Get
Support From Family Support From Family Version 4 - Social/Family Well-Being: I get emotional Emotional Support From
support from my family. My Family
C127443 FAC001-I Am Able to FAC001-I Am Able to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
Enjoy Life Enjoy Life Version 4 - Functional Well-Being: I am able to enjoy life. Able to Enjoy Life
C127441 FAC001-I Am Able to FAC001-I Am Able to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
Work Work Version 4 - Functional Well-Being: I am able to work Able to Work
C127427 FAC001-I Am Forced to FAC001-I Am Forced to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
Spend Time in Bed Spend Time in Bed Version 4 - Physical Well-Being: I am forced to spend Forced to Spend Time in
time in bed. Bed
C127434 FAC001-I Am Satisfied FAC001-I Am Satisfied Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
With My Sex Life With My Sex Life Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With My Sex Life
my sex life.
C127445 FAC001-I Am Sleeping FAC001-I Am Sleeping Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Am
Well Well Version 4 - Functional Well-Being: I am sleeping well. Sleeping Well
C127428 FAC001-I Feel Close to FAC001-I Feel Close to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
My Friends My Friends Version 4 - Social/Family Well-Being: I feel close to my Close to My Friends
friends.
C127433 FAC001-I Feel Close to FAC001-I Feel Close to Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
My Partner My Partner Version 4 - Social/Family Well-Being: I feel close to my Close to My Partner
C127426 FAC001-I Feel Ill FAC001-I Feel Ill Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
C127438 FAC001-I Feel Nervous FAC001-I Feel Nervous Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
C127435 FAC001-I Feel Sad FAC001-I Feel Sad Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Feel
C127430 FAC001-I Get Support FAC001-I Get Support Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I Get
From My Friends From My Friends Version 4 - Social/Family Well-Being: I get support from Support From My Friends
my friends.
C127421 FAC001-I Have a Lack of FAC001-I Have a Lack of Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
Energy Energy Version 4 - Physical Well-Being: I have a lack of energy. Have a Lack of Energy
C127444 FAC001-I Have Accepted FAC001-I Have Accepted Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
My Illness My Illness Version 4 - Functional Well-Being: I have accepted my Have Accepted My Illness
illness.
C127422 FAC001-I Have Nausea FAC001-I Have Nausea Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
C127424 FAC001-I Have Pain FAC001-I Have Pain Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
Version 4 - Physical Well-Being: I have pain. have pain
C127439 FAC001-I Worry About FAC001-I Worry About Functional Assessment of Cancer Therapy-General FACT-G Version 4 - I
Dying Dying Version 4 - Emotional Well-Being: I worry about dying. Worry About Dying
C127437 FAC001-Losing Hope FAC001-Losing Hope Functional Assessment of Cancer Therapy-General FACT-G Version 4 -
Against Illness Against Illness Version 4 - Emotional Well-Being: I am losing hope in the Losing Hope Against
C127431 FAC001-My Family Has FAC001-My Family Has Functional Assessment of Cancer Therapy-General FACT-G Version 4 - My
Accepted My Illness Accepted My Illness Version 4 - Social/Family Well-Being: My family has Family Has Accepted My
page 497 of 1925

C127353 FAC001TN
Code Value
C127442 FAC001-My Work Is FAC001-My Work Is Functional Assessment of Cancer Therapy-General FACT-G Version 4 - My
Fulfilling Fulfilling Version 4 - Functional Well-Being: My work (include work Work Is Fulfilling
C127432 FAC001-Satisfied FAC001-Satisfied Functional Assessment of Cancer Therapy-General FACT-G Version 4 -

Communication Illness Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With Family
C127436 FAC001-Satisfied With FAC001-Satisfied With Functional Assessment of Cancer Therapy-General FACT-G Version 4 -
How I Am Coping How I Am Coping Version 4 - Emotional Well-Being: I am satisfied with how Satisfied With How I Am
I am coping with my illness. Coping With Illness
C127423 FAC001-Trouble Meeting FAC001-Trouble Meeting Functional Assessment of Cancer Therapy-General FACT-G Version 4 -
Needs of Family Needs of Family Version 4 - Physical Well-Being: Because of my physical Trouble Meeting Needs of
C127440 FAC001-Worry My FAC001-Worry My Functional Assessment of Cancer Therapy-General FACT-G Version 4 - Worry
Condition Will Get Worse Condition Will Get Worse Version 4 - Emotional Well-Being: I worry that my My Condition Will Get
page 498 of 1925

FAC005TC (Functional Assessment of Cancer Therapy-Breast Version 4 Questionnaire Test Code)
C129094 FAC005TC
Code Value
C129188 FAC00501 FAC005-I Have a Lack of Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
Energy 4 - Physical Well-Being: I have a lack of energy. Have a Lack of Energy
C129189 FAC00502 FAC005-I Have Nausea Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
4 - Physical Well-Being: I have nausea. Have Nausea
C129190 FAC00503 FAC005-Trouble Meeting Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Needs of Family 4 - Physical Well-Being: Because of my physical Trouble Meeting Needs of
C129191 FAC00504 FAC005-I Have Pain Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
4 - Physical Well-Being: I have pain. Have Pain
C129192 FAC00505 FAC005-Bothered by Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Treatment Side Effect 4 - Physical Well-Being: I am bothered by side effects of Bothered by Treatment
treatment. Side Effect
C129193 FAC00506 FAC005-I Feel Ill Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
4 - Physical Well-Being: I feel ill. Ill
C129194 FAC00507 FAC005-I Am Forced to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Spend Time in Bed 4 - Physical Well-Being: I am forced to spend time in bed. Forced to Spend Time in
Bed
C129195 FAC00508 FAC005-I Feel Close to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
My Friends 4 - Social/Family Well-Being: I feel close to my friends. Close to My Friends
C129196 FAC00509 FAC005-Get Emotional Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Get
Support From Family 4 - Social/Family Well-Being: I get emotional support Emotional Support From
from my family. Family
C129197 FAC00510 FAC005-I Get Support Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Get
From My Friends 4 - Social/Family Well-Being: I get support from my Support From My Friends
friends.
C129198 FAC00511 FAC005-My Family Has Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - My
Accepted My Illness 4 - Social/Family Well-Being: My family has accepted my Family Has Accepted My
illness. Illness
C129199 FAC00512 FAC005-Satisfied Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Communication Illness 4 - Social/Family Well-Being: I am satisfied with family Satisfied Family
communication about my illness. Communication of Illness
C129200 FAC00513 FAC005-I Feel Close to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
My Partner 4 - Social/Family Well-Being: I feel close to my partner Close to My Partner
(or the person who is my main support).
C129201 FAC00514 FAC005-I Am Satisfied Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
With My Sex Life 4 - Social/Family Well-Being: I am satisfied with my sex Satisfied With My Sex Life
life.
C129202 FAC00515 FAC005-I Feel Sad Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
4 - Emotional Well-Being: I feel sad. Sad
C129203 FAC00516 FAC005-Satisfied With Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
How I Am Coping 4 - Emotional Well-Being: I am satisfied with how I am Satisfied With How I Am
coping with my illness. Coping
C129204 FAC00517 FAC005-Losing Hope Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Losing
Against Illness 4 - Emotional Well-Being: I am losing hope in the fight Hope Against Illness
against my illness.
C129205 FAC00518 FAC005-I Feel Nervous Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
4 - Emotional Well-Being: I feel nervous. Nervous
C129206 FAC00519 FAC005-I Worry About Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
Dying 4 - Emotional Well-Being: I worry about dying. Worry About Dying
C129207 FAC00520 FAC005-Worry My Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Worry
Condition Will Get Worse 4 - Emotional Well-Being: I worry that my condition will My Condition Will Get
get worse. Worse
C129208 FAC00521 FAC005-I Am Able to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Work 4 - Functional Well-Being: I am able to work (include Able to Work
work at home).
C129209 FAC00522 FAC005-My Work Is Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - My
Fulfilling 4 - Functional Well-Being: My work (include work at Work Is Fulfilling
home) is fulfilling.
page 499 of 1925

C129094 FAC005TC
Code Value
C129210 FAC00523 FAC005-I Am Able to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Enjoy Life 4 - Functional Well-Being: I am able to enjoy life. Able to Enjoy Life
C129211 FAC00524 FAC005-I Have Accepted Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
My Illness 4 - Functional Well-Being: I have accepted my illness. Have Accepted My Illness
C129212 FAC00525 FAC005-I Am Sleeping Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Well 4 - Functional Well-Being: I am sleeping well. Sleeping Well
C129213 FAC00526 FAC005-Enjoy Things I Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Enjoy
Usually Do for Fun 4 - Functional Well-Being: I am enjoying the things I Things I Usually Do for
usually do for fun. Fun
C129214 FAC00527 FAC005-Content With Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Quality of My Life 4 - Functional Well-Being: I am content with the quality Content With Quality of
of my life right now. My Life
C129215 FAC00528 FAC005-I Have Been Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
Short of Breath 4 - Additional Concerns: I have been short of breath. Have Been Short of
Breath
C129216 FAC00529 FAC005-Self-conscious Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Self-
About Way I Dress 4 - Additional Concerns: I am self-conscious about the conscious About Way I
way I dress. Dress
C129217 FAC00530 FAC005-One/Both Arms Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - One
Are Swollen/Tender 4 - Additional Concerns: One or both of my arms are or Both Arms Are Swollen
swollen or tender. or Tender
C129218 FAC00531 FAC005-I Feel Sexually Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
Attractive 4 - Additional Concerns: I feel sexually attractive. Sexually Attractive
C129219 FAC00532 FAC005-I Am Bothered Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
by Hair Loss 4 - Additional Concerns: I am bothered by hair loss. Bothered by Hair Loss
C129220 FAC00533 FAC005-Worry Family Will Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Worry
Get Illness 4 - Additional Concerns: I worry that other members of Family Will Get Illness
my family might someday get the same illness I have.
C129221 FAC00534 FAC005-Worry About the Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Worry
Effect of Stress 4 - Additional Concerns: I worry about the effect of stress About the Effect of Stress
on my illness.
C129222 FAC00535 FAC005-I Am Bothered Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
by Change in Weight 4 - Additional Concerns: I am bothered by a change in Bothered by Change in
weight. Weight
C129223 FAC00536 FAC005-I Am Able to Feel Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Like a Woman 4 - Additional Concerns: I am able to feel like a woman. Able to Feel Like a
Woman
C129224 FAC00537 FAC005-Certain Parts of Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Body Have Pain 4 - Additional Concerns: I have certain parts of my body Certain Parts of Body
where I experience pain. Have Pain
page 500 of 1925

FAC005TN (Functional Assessment of Cancer Therapy-Breast Version 4 Questionnaire Test Name)
C129093 FAC005TN
Code Value
C129192 FAC005-Bothered by FAC005-Bothered by Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Treatment Side Effect Treatment Side Effect 4 - Physical Well-Being: I am bothered by side effects of Bothered by Treatment
C129224 FAC005-Certain Parts of FAC005-Certain Parts of Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Body Have Pain Body Have Pain 4 - Additional Concerns: I have certain parts of my body Certain Parts of Body
where I experience pain. Have Pain
C129214 FAC005-Content With FAC005-Content With Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Quality of My Life Quality of My Life 4 - Functional Well-Being: I am content with the quality Content With Quality of
C129213 FAC005-Enjoy Things I FAC005-Enjoy Things I Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Enjoy
Usually Do for Fun Usually Do for Fun 4 - Functional Well-Being: I am enjoying the things I Things I Usually Do for
C129196 FAC005-Get Emotional FAC005-Get Emotional Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Get
Support From Family Support From Family 4 - Social/Family Well-Being: I get emotional support Emotional Support From
from my family. Family
C129210 FAC005-I Am Able to FAC005-I Am Able to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Enjoy Life Enjoy Life 4 - Functional Well-Being: I am able to enjoy life. Able to Enjoy Life
C129223 FAC005-I Am Able to Feel FAC005-I Am Able to Feel Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Like a Woman Like a Woman 4 - Additional Concerns: I am able to feel like a woman. Able to Feel Like a
Woman
C129208 FAC005-I Am Able to FAC005-I Am Able to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Work Work 4 - Functional Well-Being: I am able to work (include Able to Work
work at home).
C129222 FAC005-I Am Bothered FAC005-I Am Bothered Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
by Change in Weight by Change in Weight 4 - Additional Concerns: I am bothered by a change in Bothered by Change in
weight. Weight
C129219 FAC005-I Am Bothered FAC005-I Am Bothered Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
by Hair Loss by Hair Loss 4 - Additional Concerns: I am bothered by hair loss. Bothered by Hair Loss
C129194 FAC005-I Am Forced to FAC005-I Am Forced to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Spend Time in Bed Spend Time in Bed 4 - Physical Well-Being: I am forced to spend time in bed. Forced to Spend Time in
Bed
C129201 FAC005-I Am Satisfied FAC005-I Am Satisfied Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
With My Sex Life With My Sex Life 4 - Social/Family Well-Being: I am satisfied with my sex Satisfied With My Sex Life
life.
C129212 FAC005-I Am Sleeping FAC005-I Am Sleeping Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Am
Well Well 4 - Functional Well-Being: I am sleeping well. Sleeping Well
C129195 FAC005-I Feel Close to FAC005-I Feel Close to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
My Friends My Friends 4 - Social/Family Well-Being: I feel close to my friends. Close to My Friends
C129200 FAC005-I Feel Close to FAC005-I Feel Close to Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
My Partner My Partner 4 - Social/Family Well-Being: I feel close to my partner Close to My Partner
C129193 FAC005-I Feel Ill FAC005-I Feel Ill Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
4 - Physical Well-Being: I feel ill. Ill
C129205 FAC005-I Feel Nervous FAC005-I Feel Nervous Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
4 - Emotional Well-Being: I feel nervous. Nervous
C129202 FAC005-I Feel Sad FAC005-I Feel Sad Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
4 - Emotional Well-Being: I feel sad. Sad
C129218 FAC005-I Feel Sexually FAC005-I Feel Sexually Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Feel
Attractive Attractive 4 - Additional Concerns: I feel sexually attractive. Sexually Attractive
C129197 FAC005-I Get Support FAC005-I Get Support Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I Get
From My Friends From My Friends 4 - Social/Family Well-Being: I get support from my Support From My Friends
friends.
C129188 FAC005-I Have a Lack of FAC005-I Have a Lack of Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
Energy Energy 4 - Physical Well-Being: I have a lack of energy. Have a Lack of Energy
C129211 FAC005-I Have Accepted FAC005-I Have Accepted Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
My Illness My Illness 4 - Functional Well-Being: I have accepted my illness. Have Accepted My Illness
page 501 of 1925

C129093 FAC005TN
Code Value
C129215 FAC005-I Have Been FAC005-I Have Been Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
Short of Breath Short of Breath 4 - Additional Concerns: I have been short of breath. Have Been Short of
Breath
C129189 FAC005-I Have Nausea FAC005-I Have Nausea Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
4 - Physical Well-Being: I have nausea. Have Nausea
C129191 FAC005-I Have Pain FAC005-I Have Pain Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
4 - Physical Well-Being: I have pain. Have Pain
C129206 FAC005-I Worry About FAC005-I Worry About Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - I
Dying Dying 4 - Emotional Well-Being: I worry about dying. Worry About Dying
C129204 FAC005-Losing Hope FAC005-Losing Hope Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Losing
Against Illness Against Illness 4 - Emotional Well-Being: I am losing hope in the fight Hope Against Illness
against my illness.
C129198 FAC005-My Family Has FAC005-My Family Has Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - My
Accepted My Illness Accepted My Illness 4 - Social/Family Well-Being: My family has accepted my Family Has Accepted My
illness. Illness
C129209 FAC005-My Work Is FAC005-My Work Is Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - My
Fulfilling Fulfilling 4 - Functional Well-Being: My work (include work at Work Is Fulfilling
C129217 FAC005-One/Both Arms FAC005-One/Both Arms Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - One
Are Swollen/Tender Are Swollen/Tender 4 - Additional Concerns: One or both of my arms are or Both Arms Are Swollen
swollen or tender. or Tender
C129199 FAC005-Satisfied FAC005-Satisfied Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Communication Illness Communication Illness 4 - Social/Family Well-Being: I am satisfied with family Satisfied Family
communication about my illness. Communication of Illness
C129203 FAC005-Satisfied With FAC005-Satisfied With Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
How I Am Coping How I Am Coping 4 - Emotional Well-Being: I am satisfied with how I am Satisfied With How I Am
C129216 FAC005-Self-conscious FAC005-Self-conscious Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Self-
About Way I Dress About Way I Dress 4 - Additional Concerns: I am self-conscious about the conscious About Way I
way I dress. Dress
C129190 FAC005-Trouble Meeting FAC005-Trouble Meeting Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 -
Needs of Family Needs of Family 4 - Physical Well-Being: Because of my physical Trouble Meeting Needs of
C129221 FAC005-Worry About the FAC005-Worry About the Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Worry
Effect of Stress Effect of Stress 4 - Additional Concerns: I worry about the effect of stress About the Effect of Stress
on my illness.
C129220 FAC005-Worry Family Will FAC005-Worry Family Will Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Worry
Get Illness Get Illness 4 - Additional Concerns: I worry that other members of Family Will Get Illness
my family might someday get the same illness I have.
C129207 FAC005-Worry My FAC005-Worry My Functional Assessment of Cancer Therapy-Breast Version FACT-B Version 4 - Worry
Condition Will Get Worse Condition Will Get Worse 4 - Emotional Well-Being: I worry that my condition will My Condition Will Get
get worse. Worse
page 502 of 1925

FAC006TC (Functional Assessment of Cancer Therapy-Bladder Version 4 Questionnaire Test Code)
C154453 FAC006TC
Code Value
C155581 FAC00601 FAC006-I Have a Lack of Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155582 FAC00602 FAC006-I Have Nausea Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155583 FAC00603 FAC006-Trouble Meeting Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
C155584 FAC00604 FAC006-I Have Pain Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Version 4 - Physical Well-Being: I have pain. Have Pain
C155585 FAC00605 FAC006-Bothered by Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

C155586 FAC00606 FAC006-I Feel Ill Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Version 4 - Physical Well-Being: I feel ill. Feel Ill
C155587 FAC00607 FAC006-I Am Forced to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
time in bed. Bed
C155588 FAC00608 FAC006-I Feel Close to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
My Friends Version 4 - Social/Family Well-Being: I feel close to my Feel Close to My Friends
friends.
C155589 FAC00609 FAC006-Get Emotional Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - Get
support from my family. Family
C155590 FAC00610 FAC006-I Get Support Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Get
my friends.
C155591 FAC00611 FAC006-My Family Has Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - My
C155592 FAC00612 FAC006-Satisfied Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied Communication
family communication about my illness. Illness
C155593 FAC00613 FAC006-I Feel Close to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
My Partner Version 4 - Social/Family Well-Being: I feel close to my Feel Close to My Partner
C155594 FAC00614 FAC006-I Am Satisfied Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
my sex life.
C155595 FAC00615 FAC006-I Feel Sad Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Version 4 - Emotional Well-Being: I feel sad. Feel Sad
C155596 FAC00616 FAC006-Satisfied With Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
I am coping with my illness. Coping
C155597 FAC00617 FAC006-Losing Hope Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
C155598 FAC00618 FAC006-I Feel Nervous Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Version 4 - Emotional Well-Being: I feel nervous. Feel Nervous
C155599 FAC00619 FAC006-I Worry About Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155600 FAC00620 FAC006-Worry My Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

Condition Will Get Worse Version 4 - Emotional Well-Being: I worry that my Worry My Condition Will
condition will get worse. Get Worse
C155601 FAC00621 FAC006-I Am Able to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
page 503 of 1925

C154453 FAC006TC
Code Value
C155602 FAC00622 FAC006-My Work Is Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - My
C155603 FAC00623 FAC006-I Am Able to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
C155604 FAC00624 FAC006-I Have Accepted Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
illness.
C155605 FAC00625 FAC006-I Am Sleeping Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
C155606 FAC00626 FAC006-Enjoy Things I Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
Usually Do for Fun Version 4 - Functional Well-Being: I am enjoying the Enjoy Things I Usually Do
things I usually do for fun. for Fun
C155607 FAC00627 FAC006-Content With Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
C155608 FAC00628 FAC006-Trouble Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

Controlling My Urine Version 4 - Additional Concerns: I have trouble controlling Trouble Controlling My
my urine. Urine
C155609 FAC00629 FAC006-I Am Losing Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
Weight Version 4 - Additional Concerns: I am losing weight. Losing Weight
C155610 FAC00630 FAC006-I Have Control of Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
My Bowels Version 4 - Additional Concerns: I have control of my Have Control of My
bowels. Bowels
C155611 FAC00631 FAC006-I Urinate More Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Frequently Version 4 - Additional Concerns: I urinate more Urinate More Frequently
frequently than usual.
C155612 FAC00632 FAC006-I Have Diarrhea Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Version 4 - Additional Concerns: I have diarrhea Have Diarrhea
(diarrhoea).
C155613 FAC00633 FAC006-I Have a Good Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Appetite Version 4 - Additional Concerns: I have a good appetite. Have a Good Appetite
C155614 FAC00634 FAC006-I Like the Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Appearance of My Body Version 4 - Additional Concerns: I like the appearance of Like the Appearance of
my body. My Body
C155615 FAC00635 FAC006-It Burns When I Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - It
Urinate Version 4 - Additional Concerns: It burns when I urinate. Burns When I Urinate
C155616 FAC00636 FAC006-I Am Interested Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
in Sex Version 4 - Additional Concerns: I am interested in sex. Interested in Sex
C155617 FAC00637 FAC006-Able to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - Able
Have/Maintain Erection Version 4 - Additional Concerns: (For men only) I am able to Have/Maintain Erection
to have and maintain an erection.
C155618 FAC00638 FAC006-Do You Have an Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - Do
Ostomy Appliance Version 4 - Additional Concerns: Do you have an ostomy You Have an Ostomy
appliance? Appliance
C155619 FAC00639 FAC006-Embarrassed by Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

Ostomy Appliance Version 4 - Additional Concerns: I am embarrassed by my Embarrassed by Ostomy
ostomy appliance. Appliance
C155620 FAC00640 FAC006-Caring for Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
Ostomy Is Difficult Version 4 - Additional Concerns: Caring for my ostomy Caring for Ostomy
appliance is difficult. Appliance Is Difficult
page 504 of 1925

FAC006TN (Functional Assessment of Cancer Therapy-Bladder Version 4 Questionnaire Test Name)
C154452 FAC006TN
Code Value
C155617 FAC006-Able to FAC006-Able to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - Able
Have/Maintain Erection Have/Maintain Erection Version 4 - Additional Concerns: (For men only) I am able to Have/Maintain Erection
to have and maintain an erection.
C155585 FAC006-Bothered by FAC006-Bothered by Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

C155620 FAC006-Caring for FAC006-Caring for Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
Ostomy Is Difficult Ostomy Is Difficult Version 4 - Additional Concerns: Caring for my ostomy Caring for Ostomy
appliance is difficult. Appliance Is Difficult
C155607 FAC006-Content With FAC006-Content With Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
C155618 FAC006-Do You Have an FAC006-Do You Have an Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - Do
Ostomy Appliance Ostomy Appliance Version 4 - Additional Concerns: Do you have an ostomy You Have an Ostomy
C155619 FAC006-Embarrassed by FAC006-Embarrassed by Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

Ostomy Appliance Ostomy Appliance Version 4 - Additional Concerns: I am embarrassed by my Embarrassed by Ostomy
C155606 FAC006-Enjoy Things I FAC006-Enjoy Things I Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
Usually Do for Fun Usually Do for Fun Version 4 - Functional Well-Being: I am enjoying the Enjoy Things I Usually Do
C155589 FAC006-Get Emotional FAC006-Get Emotional Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - Get
C155603 FAC006-I Am Able to FAC006-I Am Able to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
C155601 FAC006-I Am Able to FAC006-I Am Able to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
C155587 FAC006-I Am Forced to FAC006-I Am Forced to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
time in bed. Bed
C155616 FAC006-I Am Interested FAC006-I Am Interested Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
in Sex in Sex Version 4 - Additional Concerns: I am interested in sex. Interested in Sex
C155609 FAC006-I Am Losing FAC006-I Am Losing Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
Weight Weight Version 4 - Additional Concerns: I am losing weight. Losing Weight
C155594 FAC006-I Am Satisfied FAC006-I Am Satisfied Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
my sex life.
C155605 FAC006-I Am Sleeping FAC006-I Am Sleeping Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Am
C155588 FAC006-I Feel Close to FAC006-I Feel Close to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
My Friends My Friends Version 4 - Social/Family Well-Being: I feel close to my Feel Close to My Friends
friends.
C155593 FAC006-I Feel Close to FAC006-I Feel Close to Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
My Partner My Partner Version 4 - Social/Family Well-Being: I feel close to my Feel Close to My Partner
C155586 FAC006-I Feel Ill FAC006-I Feel Ill Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155598 FAC006-I Feel Nervous FAC006-I Feel Nervous Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155595 FAC006-I Feel Sad FAC006-I Feel Sad Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155590 FAC006-I Get Support FAC006-I Get Support Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I Get
my friends.
C155613 FAC006-I Have a Good FAC006-I Have a Good Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Appetite Appetite Version 4 - Additional Concerns: I have a good appetite. Have a Good Appetite
page 505 of 1925

C154452 FAC006TN
Code Value
C155581 FAC006-I Have a Lack of FAC006-I Have a Lack of Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155604 FAC006-I Have Accepted FAC006-I Have Accepted Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
illness.
C155610 FAC006-I Have Control of FAC006-I Have Control of Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
My Bowels My Bowels Version 4 - Additional Concerns: I have control of my Have Control of My
bowels. Bowels
C155612 FAC006-I Have Diarrhea FAC006-I Have Diarrhea Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
(diarrhoea).
C155582 FAC006-I Have Nausea FAC006-I Have Nausea Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155584 FAC006-I Have Pain FAC006-I Have Pain Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155614 FAC006-I Like the FAC006-I Like the Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Appearance of My Body Appearance of My Body Version 4 - Additional Concerns: I like the appearance of Like the Appearance of
my body. My Body
C155611 FAC006-I Urinate More FAC006-I Urinate More Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
Frequently Frequently Version 4 - Additional Concerns: I urinate more Urinate More Frequently
C155599 FAC006-I Worry About FAC006-I Worry About Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - I
C155615 FAC006-It Burns When I FAC006-It Burns When I Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - It
Urinate Urinate Version 4 - Additional Concerns: It burns when I urinate. Burns When I Urinate
C155597 FAC006-Losing Hope FAC006-Losing Hope Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
C155591 FAC006-My Family Has FAC006-My Family Has Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - My
C155602 FAC006-My Work Is FAC006-My Work Is Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 - My
C155592 FAC006-Satisfied FAC006-Satisfied Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

Communication Illness Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied Communication
C155596 FAC006-Satisfied With FAC006-Satisfied With Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
C155608 FAC006-Trouble FAC006-Trouble Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

Controlling My Urine Controlling My Urine Version 4 - Additional Concerns: I have trouble controlling Trouble Controlling My
my urine. Urine
C155583 FAC006-Trouble Meeting FAC006-Trouble Meeting Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -
C155600 FAC006-Worry My FAC006-Worry My Functional Assessment of Cancer Therapy-Bladder FACT-BL Version 4 -

Condition Will Get Worse Condition Will Get Worse Version 4 - Emotional Well-Being: I worry that my Worry My Condition Will
page 506 of 1925

FAC008TC (Functional Assessment of Cancer Therapy-Colorectal Version 4 Questionnaire Test Code)
C150774 FAC008TC
Code Value
C151076 FAC00801 FAC008-I Have a Lack of Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151077 FAC00802 FAC008-I Have Nausea Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151078 FAC00803 FAC008-Trouble Meeting Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -
C151079 FAC00804 FAC008-I Have Pain Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151080 FAC00805 FAC008-Bothered by Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -

C151081 FAC00806 FAC008-I Feel Ill Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
C151082 FAC00807 FAC008-I Am Forced to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
time in bed. Bed
C151083 FAC00808 FAC008-I Feel Close to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
friends.
C151084 FAC00809 FAC008-Get Emotional Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Get
C151085 FAC00810 FAC008-I Get Support Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Get
my friends.
C151086 FAC00811 FAC008-My Family Has Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - My
C151087 FAC00812 FAC008-Satisfied Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -

C151088 FAC00813 FAC008-I Feel Close to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
C151089 FAC00814 FAC008-I Am Satisfied Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
my sex life.
C151090 FAC00815 FAC008-I Feel Sad Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
C151091 FAC00816 FAC008-Satisfied With Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -
C151092 FAC00817 FAC008-Losing Hope Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Losing
Against Illness Version 4 - Emotional Well-Being: I am losing hope in the Hope Against Illness
fight against my illness.
C151093 FAC00818 FAC008-I Feel Nervous Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
C151094 FAC00819 FAC008-I Worry About Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151095 FAC00820 FAC008-Worry My Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Worry
C151096 FAC00821 FAC008-I Am Able to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
page 507 of 1925

C150774 FAC008TC
Code Value
C151097 FAC00822 FAC008-My Work Is Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - My
C151098 FAC00823 FAC008-I Am Able to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
C151099 FAC00824 FAC008-I Have Accepted Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
illness.
C151100 FAC00825 FAC008-I Am Sleeping Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
C151101 FAC00826 FAC008-Enjoy Things I Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Enjoy
C151102 FAC00827 FAC008-Content With Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -
C151103 FAC00828 FAC008-Swelling/Cramps Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -

in Stomach Area Version 4 - Additional Concerns: I have swelling or Swelling/Cramps in
cramps in my stomach area. Stomach Area
C151104 FAC00829 FAC008-I Am Losing Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
C151105 FAC00830 FAC008-I Have Control of Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
bowels. Bowels
C151106 FAC00831 FAC008-I Can Digest My Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Can
Food Well Version 4 - Additional Concerns: I can digest my food Digest My Food Well
well.
C151107 FAC00832 FAC008-I Have Diarrhea Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
(diarrhoea).
C151108 FAC00833 FAC008-I Have a Good Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151109 FAC00834 FAC008-I Like the Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Like
Appearance of My Body Version 4 - Additional Concerns: I like the appearance of the Appearance of My
my body. Body
C151110 FAC00835 FAC008-Do You Have an Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Do
Ostomy Appliance Version 4 - Additional Concerns: Do you have an ostomy You Have an Ostomy
C151111 FAC00836 FAC008-Embarrassed by Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -

Ostomy Appliance Version 4 - Additional Concerns: I am embarrassed by my Embarrassed by Ostomy
C151112 FAC00837 FAC008-Caring for Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -
Ostomy Is Difficult Version 4 - Additional Concerns: Caring for my ostomy Caring for Ostomy Is
appliance is difficult. Difficult
page 508 of 1925

FAC008TN (Functional Assessment of Cancer Therapy-Colorectal Version 4 Questionnaire Test Name)
C150773 FAC008TN
Code Value
C151080 FAC008-Bothered by FAC008-Bothered by Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -

C151112 FAC008-Caring for FAC008-Caring for Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -
Ostomy Is Difficult Ostomy Is Difficult Version 4 - Additional Concerns: Caring for my ostomy Caring for Ostomy Is
appliance is difficult. Difficult
C151102 FAC008-Content With FAC008-Content With Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -
C151110 FAC008-Do You Have an FAC008-Do You Have an Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Do
Ostomy Appliance Ostomy Appliance Version 4 - Additional Concerns: Do you have an ostomy You Have an Ostomy
C151111 FAC008-Embarrassed by FAC008-Embarrassed by Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -

Ostomy Appliance Ostomy Appliance Version 4 - Additional Concerns: I am embarrassed by my Embarrassed by Ostomy
C151101 FAC008-Enjoy Things I FAC008-Enjoy Things I Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Enjoy
C151084 FAC008-Get Emotional FAC008-Get Emotional Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Get
C151098 FAC008-I Am Able to FAC008-I Am Able to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
C151096 FAC008-I Am Able to FAC008-I Am Able to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
C151082 FAC008-I Am Forced to FAC008-I Am Forced to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
time in bed. Bed
C151104 FAC008-I Am Losing FAC008-I Am Losing Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
C151089 FAC008-I Am Satisfied FAC008-I Am Satisfied Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
my sex life.
C151100 FAC008-I Am Sleeping FAC008-I Am Sleeping Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Am
C151106 FAC008-I Can Digest My FAC008-I Can Digest My Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Can
Food Well Food Well Version 4 - Additional Concerns: I can digest my food Digest My Food Well
well.
C151083 FAC008-I Feel Close to FAC008-I Feel Close to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
friends.
C151088 FAC008-I Feel Close to FAC008-I Feel Close to Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
C151081 FAC008-I Feel Ill FAC008-I Feel Ill Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
C151093 FAC008-I Feel Nervous FAC008-I Feel Nervous Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
C151090 FAC008-I Feel Sad FAC008-I Feel Sad Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Feel
C151085 FAC008-I Get Support FAC008-I Get Support Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Get
my friends.
C151108 FAC008-I Have a Good FAC008-I Have a Good Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151076 FAC008-I Have a Lack of FAC008-I Have a Lack of Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
page 509 of 1925

C150773 FAC008TN
Code Value
C151099 FAC008-I Have Accepted FAC008-I Have Accepted Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
illness.
C151105 FAC008-I Have Control of FAC008-I Have Control of Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
bowels. Bowels
C151107 FAC008-I Have Diarrhea FAC008-I Have Diarrhea Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
(diarrhoea).
C151077 FAC008-I Have Nausea FAC008-I Have Nausea Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151079 FAC008-I Have Pain FAC008-I Have Pain Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151109 FAC008-I Like the FAC008-I Like the Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I Like
Appearance of My Body Appearance of My Body Version 4 - Additional Concerns: I like the appearance of the Appearance of My
my body. Body
C151094 FAC008-I Worry About FAC008-I Worry About Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - I
C151092 FAC008-Losing Hope FAC008-Losing Hope Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Losing
Against Illness Against Illness Version 4 - Emotional Well-Being: I am losing hope in the Hope Against Illness
C151086 FAC008-My Family Has FAC008-My Family Has Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - My
C151097 FAC008-My Work Is FAC008-My Work Is Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - My
C151087 FAC008-Satisfied FAC008-Satisfied Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -

C151091 FAC008-Satisfied With FAC008-Satisfied With Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -
C151103 FAC008-Swelling/Cramps FAC008-Swelling/Cramps Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -

in Stomach Area in Stomach Area Version 4 - Additional Concerns: I have swelling or Swelling/Cramps in
C151078 FAC008-Trouble Meeting FAC008-Trouble Meeting Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 -
C151095 FAC008-Worry My FAC008-Worry My Functional Assessment of Cancer Therapy-Colorectal FACT-C Version 4 - Worry
page 510 of 1925

FAC015TC (Functional Assessment of Cancer Therapy-Hepatobiliary Version 4 Questionnaire Test
Code)
C130255 FAC015TC
Code Value
C130458 FAC01501 FAC015-I Have a Lack of Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130459 FAC01502 FAC015-I Have Nausea Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130460 FAC01503 FAC015-Trouble Meeting Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130461 FAC01504 FAC015-I Have Pain Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130462 FAC01505 FAC015-Bothered by Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

C130463 FAC01506 FAC015-I Feel Ill Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130464 FAC01507 FAC015-I Am Forced to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Spend Time in Bed Version 4 - Physical Well-Being: I am forced to spend Am Forced to Spend Time
time in bed. in Bed
C130465 FAC01508 FAC015-I Feel Close to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
friends.
C130466 FAC01509 FAC015-Get Emotional Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - Get
C130467 FAC01510 FAC015-I Get Support Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
From My Friends Version 4 - Social/Family Well-Being: I get support from Get Support From My
my friends. Friends
C130468 FAC01511 FAC015-My Family Has Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - My
C130469 FAC01512 FAC015-Satisfied Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With
family communication about my illness. Communication About
Illness
C130470 FAC01513 FAC015-I Feel Close to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130471 FAC01514 FAC015-I Am Satisfied Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
With My Sex Life Version 4 - Social/Family Well-Being: I am satisfied with Am Satisfied With My Sex
my sex life. Life
C130472 FAC01515 FAC015-I Feel Sad Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130473 FAC01516 FAC015-Satisfied With Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130474 FAC01517 FAC015-Losing Hope Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130475 FAC01518 FAC015-I Feel Nervous Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130476 FAC01519 FAC015-I Worry About Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130477 FAC01520 FAC015-Worry My Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

C130478 FAC01521 FAC015-I Am Able to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Work Version 4 - Functional Well-Being: I am able to work Am Able to Work
page 511 of 1925

C130255 FAC015TC
Code Value
C130479 FAC01522 FAC015-My Work Is Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - My
C130480 FAC01523 FAC015-I Am Able to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Enjoy Life Version 4 - Functional Well-Being: I am able to enjoy life. Am Able to Enjoy Life
C130481 FAC01524 FAC015-I Have Accepted Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
illness.
C130482 FAC01525 FAC015-I Am Sleeping Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Well Version 4 - Functional Well-Being: I am sleeping well. Am Sleeping Well
C130483 FAC01526 FAC015-Enjoy Things I Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130484 FAC01527 FAC015-Content With Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130485 FAC01528 FAC015-Swelling/Cramps Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

in Stomach Area Version 4 - Additional Concerns: I have swelling or Swelling or Cramps in
C130486 FAC01529 FAC015-I Am Losing Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Weight Version 4 - Additional Concerns: I am losing weight. Am Losing Weight
C130487 FAC01530 FAC015-I Have Control of Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
bowels. Bowels
C130488 FAC01531 FAC015-I Can Digest My Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Food Well Version 4 - Additional Concerns: I can digest my food Can Digest My Food Well
well.
C130489 FAC01532 FAC015-I Have Diarrhea Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
(diarrhoea).
C130490 FAC01533 FAC015-I Have a Good Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130491 FAC01534 FAC015-Unhappy About Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
Change in My Appear Version 4 - Additional Concerns: I am unhappy about a Unhappy About Change in
change in my appearance. My Appearance
C130492 FAC01535 FAC015-I Have Pain in My Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Back Version 4 - Additional Concerns: I have pain in my back. Have Pain in My Back
C130493 FAC01536 FAC015-I Am Bothered Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
by Constipation Version 4 - Additional Concerns: I am bothered by Am Bothered by
constipation. Constipation
C130494 FAC01537 FAC015-I Feel Fatigued Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Version 4 - Additional Concerns: I feel fatigued. Feel Fatigued
C130495 FAC01538 FAC015-Able to Do My Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

Usual Activities Version 4 - Additional Concerns: I am able to do my usual Able to Do My Usual
activities. Activities
C130496 FAC01539 FAC015-Bothered by Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

Jaundice/Yellow Skin Version 4 - Additional Concerns: I am bothered by Bothered by Jaundice or
jaundice or yellow color to my skin. Yellow Skin
C130497 FAC01540 FAC015-I Have Had Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Fevers Version 4 - Additional Concerns: I have had fevers Have Had Fevers
(episodes of high body temperature).
C130498 FAC01541 FAC015-I Have Had Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Itching Version 4 - Additional Concerns: I have had itching. Have Had Itching
C130499 FAC01542 FAC015-Had Change in Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
the Way Food Tastes Version 4 - Additional Concerns: I have had a change in Had Change in the Way
the way food tastes. Food Tastes
C130500 FAC01543 FAC015-I Have Had Chills Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Version 4 - Additional Concerns: I have had chills. Have Had Chills
C130501 FAC01544 FAC015-My Mouth Is Dry Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - My
Version 4 - Additional Concerns: My mouth is dry. Mouth Is Dry
page 512 of 1925

C130255 FAC015TC
Code Value
C130502 FAC01545 FAC015-Discomfort/Pain Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

in Stomach Area Version 4 - Additional Concerns: I have discomfort or pain Discomfort or Pain in
in my stomach area. Stomach Area
page 513 of 1925

FAC015TN (Functional Assessment of Cancer Therapy-Hepatobiliary Version 4 Questionnaire Test
Name)
C130254 FAC015TN
Code Value
C130495 FAC015-Able to Do My FAC015-Able to Do My Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

Usual Activities Usual Activities Version 4 - Additional Concerns: I am able to do my usual Able to Do My Usual
C130496 FAC015-Bothered by FAC015-Bothered by Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

Jaundice/Yellow Skin Jaundice/Yellow Skin Version 4 - Additional Concerns: I am bothered by Bothered by Jaundice or
jaundice or yellow color to my skin. Yellow Skin
C130462 FAC015-Bothered by FAC015-Bothered by Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

C130484 FAC015-Content With FAC015-Content With Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130502 FAC015-Discomfort/Pain FAC015-Discomfort/Pain Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

in Stomach Area in Stomach Area Version 4 - Additional Concerns: I have discomfort or pain Discomfort or Pain in
in my stomach area. Stomach Area
C130483 FAC015-Enjoy Things I FAC015-Enjoy Things I Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130466 FAC015-Get Emotional FAC015-Get Emotional Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - Get
C130499 FAC015-Had Change in FAC015-Had Change in Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
the Way Food Tastes the Way Food Tastes Version 4 - Additional Concerns: I have had a change in Had Change in the Way
the way food tastes. Food Tastes
C130480 FAC015-I Am Able to FAC015-I Am Able to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Enjoy Life Enjoy Life Version 4 - Functional Well-Being: I am able to enjoy life. Am Able to Enjoy Life
C130478 FAC015-I Am Able to FAC015-I Am Able to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Work Work Version 4 - Functional Well-Being: I am able to work Am Able to Work
C130493 FAC015-I Am Bothered FAC015-I Am Bothered Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
by Constipation by Constipation Version 4 - Additional Concerns: I am bothered by Am Bothered by
constipation. Constipation
C130464 FAC015-I Am Forced to FAC015-I Am Forced to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Spend Time in Bed Spend Time in Bed Version 4 - Physical Well-Being: I am forced to spend Am Forced to Spend Time
time in bed. in Bed
C130486 FAC015-I Am Losing FAC015-I Am Losing Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Weight Weight Version 4 - Additional Concerns: I am losing weight. Am Losing Weight
C130471 FAC015-I Am Satisfied FAC015-I Am Satisfied Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
With My Sex Life With My Sex Life Version 4 - Social/Family Well-Being: I am satisfied with Am Satisfied With My Sex
my sex life. Life
C130482 FAC015-I Am Sleeping FAC015-I Am Sleeping Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Well Well Version 4 - Functional Well-Being: I am sleeping well. Am Sleeping Well
C130488 FAC015-I Can Digest My FAC015-I Can Digest My Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Food Well Food Well Version 4 - Additional Concerns: I can digest my food Can Digest My Food Well
well.
C130465 FAC015-I Feel Close to FAC015-I Feel Close to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
friends.
C130470 FAC015-I Feel Close to FAC015-I Feel Close to Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130494 FAC015-I Feel Fatigued FAC015-I Feel Fatigued Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Version 4 - Additional Concerns: I feel fatigued. Feel Fatigued
C130463 FAC015-I Feel Ill FAC015-I Feel Ill Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130475 FAC015-I Feel Nervous FAC015-I Feel Nervous Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
page 514 of 1925

C130254 FAC015TN
Code Value
C130472 FAC015-I Feel Sad FAC015-I Feel Sad Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130467 FAC015-I Get Support FAC015-I Get Support Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
From My Friends From My Friends Version 4 - Social/Family Well-Being: I get support from Get Support From My
my friends. Friends
C130490 FAC015-I Have a Good FAC015-I Have a Good Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130458 FAC015-I Have a Lack of FAC015-I Have a Lack of Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130481 FAC015-I Have Accepted FAC015-I Have Accepted Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
illness.
C130487 FAC015-I Have Control of FAC015-I Have Control of Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
bowels. Bowels
C130489 FAC015-I Have Diarrhea FAC015-I Have Diarrhea Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
(diarrhoea).
C130500 FAC015-I Have Had Chills FAC015-I Have Had Chills Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Version 4 - Additional Concerns: I have had chills. Have Had Chills
C130497 FAC015-I Have Had FAC015-I Have Had Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Fevers Fevers Version 4 - Additional Concerns: I have had fevers Have Had Fevers
C130498 FAC015-I Have Had FAC015-I Have Had Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Itching Itching Version 4 - Additional Concerns: I have had itching. Have Had Itching
C130459 FAC015-I Have Nausea FAC015-I Have Nausea Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130461 FAC015-I Have Pain FAC015-I Have Pain Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130492 FAC015-I Have Pain in My FAC015-I Have Pain in My Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
Back Back Version 4 - Additional Concerns: I have pain in my back. Have Pain in My Back
C130476 FAC015-I Worry About FAC015-I Worry About Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - I
C130474 FAC015-Losing Hope FAC015-Losing Hope Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130468 FAC015-My Family Has FAC015-My Family Has Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - My
C130501 FAC015-My Mouth Is Dry FAC015-My Mouth Is Dry Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - My
Version 4 - Additional Concerns: My mouth is dry. Mouth Is Dry
C130479 FAC015-My Work Is FAC015-My Work Is Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 - My
C130469 FAC015-Satisfied FAC015-Satisfied Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

Communication Illness Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With
Illness
C130473 FAC015-Satisfied With FAC015-Satisfied With Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130485 FAC015-Swelling/Cramps FAC015-Swelling/Cramps Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

in Stomach Area in Stomach Area Version 4 - Additional Concerns: I have swelling or Swelling or Cramps in
C130460 FAC015-Trouble Meeting FAC015-Trouble Meeting Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
C130491 FAC015-Unhappy About FAC015-Unhappy About Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -
Change in My Appear Change in My Appear Version 4 - Additional Concerns: I am unhappy about a Unhappy About Change in
change in my appearance. My Appearance
page 515 of 1925

C130254 FAC015TN
Code Value
C130477 FAC015-Worry My FAC015-Worry My Functional Assessment of Cancer Therapy-Hepatobiliary FACT-HEP Version 4 -

page 516 of 1925

FAC016TC (Functional Assessment of Cancer Therapy-Lung Version 4 Questionnaire Test Code)
C150782 FAC016TC
Code Value
C151234 FAC01601 FAC016-I Have a Lack of Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
Energy - Physical Well-Being: I have a lack of energy. a Lack of Energy
C151235 FAC01602 FAC016-I Have Nausea Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
- Physical Well-Being: I have nausea. Nausea
C151236 FAC01603 FAC016-Trouble Meeting Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
Needs of Family - Physical Well-Being: Because of my physical condition, I Trouble Meeting Needs of
have trouble meeting the needs of my family. Family
C151237 FAC01604 FAC016-I Have Pain Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
- Physical Well-Being: I have pain. Pain
C151238 FAC01605 FAC016-Bothered by Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
Treatment Side Effect - Physical Well-Being: I am bothered by side effects of Bothered by Treatment
C151239 FAC01606 FAC016-I Feel Ill Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
- Physical Well-Being: I feel ill. Ill
C151240 FAC01607 FAC016-I am Forced to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I am
Spend Time in Bed - Physical Well-Being: I am forced to spend time in bed. Forced to Spend Time in
Bed
C151241 FAC01608 FAC016-I Feel Close to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
My Friends - Social/Family Well-Being: I feel close to my friends. Close to My Friends
C151242 FAC01609 FAC016-Get Emotional Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Get
Support From Family - Social/Family Well-Being: I get emotional support from Emotional Support From
my family. Family
C151243 FAC01610 FAC016-I Get Support Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Get
From My Friends - Social/Family Well-Being: I get support from my Support From My Friends
friends.
C151244 FAC01611 FAC016-My Family Has Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - My
Accepted My Illness - Social/Family Well-Being: My family has accepted my Family Has Accepted My
illness. Illness
C151245 FAC01612 FAC016-Satisfied Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
Communication Illness - Social/Family Well-Being: I am satisfied with family Satisfied Communication
communication about my illness. Illness
C151246 FAC01613 FAC016-I Feel Close to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
My Partner - Social/Family Well-Being: I feel close to my partner (or Close to My Partner
the person who is my main support).
C151247 FAC01614 FAC016-I Am Satisfied Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
With My Sex Life - Social/Family Well-Being: I am satisfied with my sex Satisfied With My Sex Life
life.
C151248 FAC01615 FAC016-I Feel Sad Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
- Emotional Well-Being: I feel sad. Sad
C151249 FAC01616 FAC016-Satisfied With Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
How I Am Coping - Emotional Well-Being: I am satisfied with how I am Satisfied With How I Am
C151250 FAC01617 FAC016-Losing Hope Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Losing
Against Illness - Emotional Well-Being: I am losing hope in the fight Hope Against Illness
against my illness.
C151251 FAC01618 FAC016-I Feel Nervous Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
- Emotional Well-Being: I feel nervous. Nervous
C151252 FAC01619 FAC016-I Worry About Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I
Dying - Emotional Well-Being: I worry about dying. Worry About Dying
C151253 FAC01620 FAC016-Worry My Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Worry
Condition Will Get Worse - Emotional Well-Being: I worry that my condition will get My Condition Will Get
worse. Worse
C151254 FAC01621 FAC016-I Am Able to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
Work - Functional Well-Being: I am able to work (include work Able to Work
at home).
C151255 FAC01622 FAC016-My Work Is Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - My
Fulfilling - Functional Well-Being: My work (include work at home) Work Is Fulfilling
is fulfilling.
page 517 of 1925

C150782 FAC016TC
Code Value
C151256 FAC01623 FAC016-I Am Able to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
Enjoy Life - Functional Well-Being: I am able to enjoy life. Able to Enjoy Life
C151257 FAC01624 FAC016-I Have Accepted Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
My Illness - Functional Well-Being: I have accepted my illness. Accepted My Illness
C151258 FAC01625 FAC016-I Am Sleeping Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
Well - Functional Well-Being: I am sleeping well. Sleeping Well
C151259 FAC01626 FAC016-Enjoy Things I Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Enjoy
Usually Do for Fun - Functional Well-Being: I am enjoying the things I Things I Usually Do for
C151260 FAC01627 FAC016-Content With Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
Quality of My Life - Functional Well-Being: I am content with the quality of Content With Quality of
my life right now. My Life
C151261 FAC01628 FAC016-I Have Been Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
Short of Breath - Additional Concerns: I have been short of breath. Been Short of Breath
C151262 FAC01629 FAC016-I Am Losing Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
Weight - Additional Concerns: I am losing weight. Losing Weight
C151263 FAC01630 FAC016-My Thinking Is Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - My
Clear - Additional Concerns: My thinking is clear. Thinking Is Clear
C151264 FAC01631 FAC016-I Have Been Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
Coughing - Additional Concerns: I have been coughing. Been Coughing
C151265 FAC01632 FAC016-I Am Bothered Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
by Hair Loss - Additional Concerns: I am bothered by hair loss. Bothered by Hair Loss
C151266 FAC01633 FAC016-I Have a Good Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
Appetite - Additional Concerns: I have a good appetite. a Good Appetite
C151267 FAC01634 FAC016-I Feel Tightness Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
in My Chest - Additional Concerns: I feel tightness in my chest. Tightness in My Chest
C151268 FAC01635 FAC016-Breathing Is Easy Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
for Me - Additional Concerns: Breathing is easy for me. Breathing Is Easy for Me
C151269 FAC01636 FAC016-Have You Ever Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Have
Smoked - Additional Concerns: Have you ever smoked? You Ever Smoked
C151270 FAC01637 FAC016-I Regret My Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I
Smoking - Additional Concerns: I regret my smoking. Regret My Smoking
page 518 of 1925

FAC016TN (Functional Assessment of Cancer Therapy-Lung Version 4 Questionnaire Test Name)
C150781 FAC016TN
Code Value
C151238 FAC016-Bothered by FAC016-Bothered by Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
Treatment Side Effect Treatment Side Effect - Physical Well-Being: I am bothered by side effects of Bothered by Treatment
C151268 FAC016-Breathing Is Easy FAC016-Breathing Is Easy Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
for Me for Me - Additional Concerns: Breathing is easy for me. Breathing Is Easy for Me
C151260 FAC016-Content With FAC016-Content With Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
Quality of My Life Quality of My Life - Functional Well-Being: I am content with the quality of Content With Quality of
C151259 FAC016-Enjoy Things I FAC016-Enjoy Things I Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Enjoy
Usually Do for Fun Usually Do for Fun - Functional Well-Being: I am enjoying the things I Things I Usually Do for
C151242 FAC016-Get Emotional FAC016-Get Emotional Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Get
Support From Family Support From Family - Social/Family Well-Being: I get emotional support from Emotional Support From
my family. Family
C151269 FAC016-Have You Ever FAC016-Have You Ever Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Have
Smoked Smoked - Additional Concerns: Have you ever smoked? You Ever Smoked
C151256 FAC016-I Am Able to FAC016-I Am Able to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
Enjoy Life Enjoy Life - Functional Well-Being: I am able to enjoy life. Able to Enjoy Life
C151254 FAC016-I Am Able to FAC016-I Am Able to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
Work Work - Functional Well-Being: I am able to work (include work Able to Work
at home).
C151265 FAC016-I Am Bothered FAC016-I Am Bothered Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
by Hair Loss by Hair Loss - Additional Concerns: I am bothered by hair loss. Bothered by Hair Loss
C151240 FAC016-I am Forced to FAC016-I am Forced to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I am
Spend Time in Bed Spend Time in Bed - Physical Well-Being: I am forced to spend time in bed. Forced to Spend Time in
Bed
C151262 FAC016-I Am Losing FAC016-I Am Losing Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
Weight Weight - Additional Concerns: I am losing weight. Losing Weight
C151247 FAC016-I Am Satisfied FAC016-I Am Satisfied Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
With My Sex Life With My Sex Life - Social/Family Well-Being: I am satisfied with my sex Satisfied With My Sex Life
life.
C151258 FAC016-I Am Sleeping FAC016-I Am Sleeping Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Am
Well Well - Functional Well-Being: I am sleeping well. Sleeping Well
C151241 FAC016-I Feel Close to FAC016-I Feel Close to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
My Friends My Friends - Social/Family Well-Being: I feel close to my friends. Close to My Friends
C151246 FAC016-I Feel Close to FAC016-I Feel Close to Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
My Partner My Partner - Social/Family Well-Being: I feel close to my partner (or Close to My Partner
the person who is my main support).
C151239 FAC016-I Feel Ill FAC016-I Feel Ill Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
- Physical Well-Being: I feel ill. Ill
C151251 FAC016-I Feel Nervous FAC016-I Feel Nervous Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
- Emotional Well-Being: I feel nervous. Nervous
C151248 FAC016-I Feel Sad FAC016-I Feel Sad Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
- Emotional Well-Being: I feel sad. Sad
C151267 FAC016-I Feel Tightness FAC016-I Feel Tightness Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Feel
in My Chest in My Chest - Additional Concerns: I feel tightness in my chest. Tightness in My Chest
C151243 FAC016-I Get Support FAC016-I Get Support Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Get
From My Friends From My Friends - Social/Family Well-Being: I get support from my Support From My Friends
friends.
C151266 FAC016-I Have a Good FAC016-I Have a Good Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
Appetite Appetite - Additional Concerns: I have a good appetite. a Good Appetite
C151234 FAC016-I Have a Lack of FAC016-I Have a Lack of Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
Energy Energy - Physical Well-Being: I have a lack of energy. a Lack of Energy
C151257 FAC016-I Have Accepted FAC016-I Have Accepted Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
My Illness My Illness - Functional Well-Being: I have accepted my illness. Accepted My Illness
page 519 of 1925

C150781 FAC016TN
Code Value
C151264 FAC016-I Have Been FAC016-I Have Been Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
Coughing Coughing - Additional Concerns: I have been coughing. Been Coughing
C151261 FAC016-I Have Been FAC016-I Have Been Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
Short of Breath Short of Breath - Additional Concerns: I have been short of breath. Been Short of Breath
C151235 FAC016-I Have Nausea FAC016-I Have Nausea Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
- Physical Well-Being: I have nausea. Nausea
C151237 FAC016-I Have Pain FAC016-I Have Pain Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I Have
- Physical Well-Being: I have pain. Pain
C151270 FAC016-I Regret My FAC016-I Regret My Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I
Smoking Smoking - Additional Concerns: I regret my smoking. Regret My Smoking
C151252 FAC016-I Worry About FAC016-I Worry About Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - I
Dying Dying - Emotional Well-Being: I worry about dying. Worry About Dying
C151250 FAC016-Losing Hope FAC016-Losing Hope Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Losing
Against Illness Against Illness - Emotional Well-Being: I am losing hope in the fight Hope Against Illness
against my illness.
C151244 FAC016-My Family Has FAC016-My Family Has Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - My
Accepted My Illness Accepted My Illness - Social/Family Well-Being: My family has accepted my Family Has Accepted My
illness. Illness
C151263 FAC016-My Thinking Is FAC016-My Thinking Is Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - My
Clear Clear - Additional Concerns: My thinking is clear. Thinking Is Clear
C151255 FAC016-My Work Is FAC016-My Work Is Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - My
Fulfilling Fulfilling - Functional Well-Being: My work (include work at home) Work Is Fulfilling
is fulfilling.
C151245 FAC016-Satisfied FAC016-Satisfied Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
Communication Illness Communication Illness - Social/Family Well-Being: I am satisfied with family Satisfied Communication
C151249 FAC016-Satisfied With FAC016-Satisfied With Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
How I Am Coping How I Am Coping - Emotional Well-Being: I am satisfied with how I am Satisfied With How I Am
C151236 FAC016-Trouble Meeting FAC016-Trouble Meeting Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 -
Needs of Family Needs of Family - Physical Well-Being: Because of my physical condition, I Trouble Meeting Needs of
C151253 FAC016-Worry My FAC016-Worry My Functional Assessment of Cancer Therapy-Lung Version 4 FACT-L Version 4 - Worry
Condition Will Get Worse Condition Will Get Worse - Emotional Well-Being: I worry that my condition will get My Condition Will Get
worse. Worse
page 520 of 1925

FAC017TC (Functional Assessment of Cancer Therapy-Leukemia Version 4 Questionnaire Test Code)
C130253 FAC017TC
Code Value
C130414 FAC01701 FAC017-I Have a Lack of Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130415 FAC01702 FAC017-I Have Nausea Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130416 FAC01703 FAC017-Trouble Meeting Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130417 FAC01704 FAC017-I Have Pain Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130418 FAC01705 FAC017-Bothered by Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

C130419 FAC01706 FAC017-I Feel Ill Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130420 FAC01707 FAC017-I Am Forced to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
time in bed. in Bed
C130421 FAC01708 FAC017-I Feel Close to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
friends.
C130422 FAC01709 FAC017-Get Emotional Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - Get
C130423 FAC01710 FAC017-I Get Support Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
my friends. Friends
C130424 FAC01711 FAC017-My Family Has Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - My
C130425 FAC01712 FAC017-Satisfied Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

C130426 FAC01713 FAC017-I Feel Close to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130427 FAC01714 FAC017-I Am Satisfied Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
my sex life. Life
C130428 FAC01715 FAC017-I Feel Sad Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130429 FAC01716 FAC017-Satisfied With Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130430 FAC01717 FAC017-Losing Hope Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130431 FAC01718 FAC017-I Feel Nervous Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130432 FAC01719 FAC017-I Worry About Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130433 FAC01720 FAC017-Worry My Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

C130434 FAC01721 FAC017-I Am Able to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
page 521 of 1925

C130253 FAC017TC
Code Value
C130435 FAC01722 FAC017-My Work Is Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - My
C130436 FAC01723 FAC017-I Am Able to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130437 FAC01724 FAC017-I Have Accepted Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
illness.
C130438 FAC01725 FAC017-I Am Sleeping Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130439 FAC01726 FAC017-Enjoy Things I Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130440 FAC01727 FAC017-Content With Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130441 FAC01728 FAC017-I Am Bothered Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
by Fevers Version 4 - Additional Concerns: I am bothered by fevers Am Bothered by Fevers
C130442 FAC01729 FAC017-Certain Parts of Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
Body Have Pain Version 4 - Additional Concerns: I have certain parts of Certain Parts of Body
my body where I experience pain. Have Pain
C130443 FAC01730 FAC017-I Am Bothered Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
by the Chills Version 4 - Additional Concerns: I am bothered by the Am Bothered by the Chills
chills.
C130444 FAC01731 FAC017-I Have Night Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Sweats Version 4 - Additional Concerns: I have night sweats. Have Night Sweats
C130445 FAC01732 FAC017-Bothered by Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

Lumps or Swelling Version 4 - Additional Concerns: I am bothered by lumps Bothered by Lumps or
or swelling in certain parts of my body (e.g., neck, Swelling
armpits, or groin).
C130446 FAC01733 FAC017-I Bleed Easily Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Version 4 - Additional Concerns: I bleed easily. Bleed Easily
C130447 FAC01734 FAC017-I Bruise Easily Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Version 4 - Additional Concerns: I bruise easily. Bruise Easily
C130448 FAC01735 FAC017-I Feel Weak All Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Over Version 4 - Additional Concerns: I feel weak all over. Feel Weak All Over
C130449 FAC01736 FAC017-I Get Tired Easily Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Version 4 - Additional Concerns: I get tired easily. Get Tired Easily
C130450 FAC01737 FAC017-I Am Losing Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130451 FAC01738 FAC017-I Have a Good Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130452 FAC01739 FAC017-Able to Do My Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

Usual Activities Version 4 - Additional Concerns: I am able to do my usual Able to Do My Usual
C130453 FAC01740 FAC017-I Worry About Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Getting Infections Version 4 - Additional Concerns: I worry about getting Worry About Getting
infections. Infections
C130454 FAC01741 FAC017-Uncertain About Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
My Future Health Version 4 - Additional Concerns: I feel uncertain about Uncertain About My
my future health. Future Health
C130455 FAC01742 FAC017-Worry I Might Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
Get New Symptoms Version 4 - Additional Concerns: I worry that I might get Worry I Might Get New
new symptoms of my illness. Symptoms
C130456 FAC01743 FAC017-I Have Emotional Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Ups and Downs Version 4 - Additional Concerns: I have emotional ups Have Emotional Ups and
and downs. Downs
C130457 FAC01744 FAC017-Feel Isolated Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
Because of Illness Version 4 - Additional Concerns: I feel isolated from Feel Isolated Because of
others because of my illness or treatment. Illness
page 522 of 1925

FAC017TN (Functional Assessment of Cancer Therapy-Leukemia Version 4 Questionnaire Test Name)
C130252 FAC017TN
Code Value
C130452 FAC017-Able to Do My FAC017-Able to Do My Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

Usual Activities Usual Activities Version 4 - Additional Concerns: I am able to do my usual Able to Do My Usual
C130445 FAC017-Bothered by FAC017-Bothered by Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

Lumps or Swelling Lumps or Swelling Version 4 - Additional Concerns: I am bothered by lumps Bothered by Lumps or
armpits, or groin).
C130418 FAC017-Bothered by FAC017-Bothered by Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

C130442 FAC017-Certain Parts of FAC017-Certain Parts of Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
Body Have Pain Body Have Pain Version 4 - Additional Concerns: I have certain parts of Certain Parts of Body
C130440 FAC017-Content With FAC017-Content With Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130439 FAC017-Enjoy Things I FAC017-Enjoy Things I Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130457 FAC017-Feel Isolated FAC017-Feel Isolated Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
Because of Illness Because of Illness Version 4 - Additional Concerns: I feel isolated from Feel Isolated Because of
C130422 FAC017-Get Emotional FAC017-Get Emotional Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - Get
C130436 FAC017-I Am Able to FAC017-I Am Able to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130434 FAC017-I Am Able to FAC017-I Am Able to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130441 FAC017-I Am Bothered FAC017-I Am Bothered Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
by Fevers by Fevers Version 4 - Additional Concerns: I am bothered by fevers Am Bothered by Fevers
C130443 FAC017-I Am Bothered FAC017-I Am Bothered Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
by the Chills by the Chills Version 4 - Additional Concerns: I am bothered by the Am Bothered by the Chills
chills.
C130420 FAC017-I Am Forced to FAC017-I Am Forced to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
time in bed. in Bed
C130450 FAC017-I Am Losing FAC017-I Am Losing Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130427 FAC017-I Am Satisfied FAC017-I Am Satisfied Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
my sex life. Life
C130438 FAC017-I Am Sleeping FAC017-I Am Sleeping Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130446 FAC017-I Bleed Easily FAC017-I Bleed Easily Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Version 4 - Additional Concerns: I bleed easily. Bleed Easily
C130447 FAC017-I Bruise Easily FAC017-I Bruise Easily Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Version 4 - Additional Concerns: I bruise easily. Bruise Easily
C130421 FAC017-I Feel Close to FAC017-I Feel Close to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
friends.
C130426 FAC017-I Feel Close to FAC017-I Feel Close to Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130419 FAC017-I Feel Ill FAC017-I Feel Ill Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
page 523 of 1925

C130252 FAC017TN
Code Value
C130431 FAC017-I Feel Nervous FAC017-I Feel Nervous Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130428 FAC017-I Feel Sad FAC017-I Feel Sad Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130448 FAC017-I Feel Weak All FAC017-I Feel Weak All Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Over Over Version 4 - Additional Concerns: I feel weak all over. Feel Weak All Over
C130423 FAC017-I Get Support FAC017-I Get Support Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
my friends. Friends
C130449 FAC017-I Get Tired Easily FAC017-I Get Tired Easily Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130451 FAC017-I Have a Good FAC017-I Have a Good Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130414 FAC017-I Have a Lack of FAC017-I Have a Lack of Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130437 FAC017-I Have Accepted FAC017-I Have Accepted Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
illness.
C130456 FAC017-I Have Emotional FAC017-I Have Emotional Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Ups and Downs Ups and Downs Version 4 - Additional Concerns: I have emotional ups Have Emotional Ups and
and downs. Downs
C130415 FAC017-I Have Nausea FAC017-I Have Nausea Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130444 FAC017-I Have Night FAC017-I Have Night Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Sweats Sweats Version 4 - Additional Concerns: I have night sweats. Have Night Sweats
C130417 FAC017-I Have Pain FAC017-I Have Pain Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130432 FAC017-I Worry About FAC017-I Worry About Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
C130453 FAC017-I Worry About FAC017-I Worry About Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - I
Getting Infections Getting Infections Version 4 - Additional Concerns: I worry about getting Worry About Getting
C130430 FAC017-Losing Hope FAC017-Losing Hope Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130424 FAC017-My Family Has FAC017-My Family Has Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - My
C130435 FAC017-My Work Is FAC017-My Work Is Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 - My
C130425 FAC017-Satisfied FAC017-Satisfied Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

C130429 FAC017-Satisfied With FAC017-Satisfied With Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130416 FAC017-Trouble Meeting FAC017-Trouble Meeting Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
C130454 FAC017-Uncertain About FAC017-Uncertain About Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
My Future Health My Future Health Version 4 - Additional Concerns: I feel uncertain about Uncertain About My
my future health. Future Health
C130455 FAC017-Worry I Might FAC017-Worry I Might Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -
Get New Symptoms Get New Symptoms Version 4 - Additional Concerns: I worry that I might get Worry I Might Get New
C130433 FAC017-Worry My FAC017-Worry My Functional Assessment of Cancer Therapy-Leukemia FACT-LEU Version 4 -

page 524 of 1925

FAC018TC (Functional Assessment of Cancer Therapy-Lymphoma Version 4 Questionnaire Test Code)
C130257 FAC018TC
Code Value
C130503 FAC01801 FAC018-I Have a Lack of Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130504 FAC01802 FAC018-I Have Nausea Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130505 FAC01803 FAC018-Trouble Meeting Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130506 FAC01804 FAC018-I Have Pain Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130507 FAC01805 FAC018-Bothered by Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

C130508 FAC01806 FAC018-I Feel Ill Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130509 FAC01807 FAC018-I Am Forced to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
time in bed. in Bed
C130510 FAC01808 FAC018-I Feel Close to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
friends.
C130511 FAC01809 FAC018-Get Emotional Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - Get
C130512 FAC01810 FAC018-I Get Support Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
my friends. Friends
C130513 FAC01811 FAC018-My Family Has Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - My
C130514 FAC01812 FAC018-Satisfied Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With
Illness
C130515 FAC01813 FAC018-I Feel Close to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130516 FAC01814 FAC018-I Am Satisfied Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
my sex life. Life
C130517 FAC01815 FAC018-I Feel Sad Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130518 FAC01816 FAC018-Satisfied With Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130519 FAC01817 FAC018-Losing Hope Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130520 FAC01818 FAC018-I Feel Nervous Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130521 FAC01819 FAC018-I Worry About Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130522 FAC01820 FAC018-Worry My Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

C130523 FAC01821 FAC018-I Am Able to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
page 525 of 1925

C130257 FAC018TC
Code Value
C130524 FAC01822 FAC018-My Work Is Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - My
C130525 FAC01823 FAC018-I Am Able to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130526 FAC01824 FAC018-I Have Accepted Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
illness.
C130527 FAC01825 FAC018-I Am Sleeping Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130528 FAC01826 FAC018-Enjoy Things I Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130529 FAC01827 FAC018-Content With Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130530 FAC01828 FAC018-Certain Parts of Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130531 FAC01829 FAC018-Bothered by Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

Lumps or Swelling Version 4 - Additional Concerns: I am bothered by lumps Bothered by Lumps or
armpits, or groin).
C130532 FAC01830 FAC018-I Am Bothered Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
by Fevers Version 4 - Additional Concerns: I am bothered by fevers Am Bothered by Fevers
C130533 FAC01831 FAC018-I Have Night Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Sweats Version 4 - Additional Concerns: I have night sweats. Have Night Sweats
C130534 FAC01832 FAC018-I Am Bothered Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
by Itching Version 4 - Additional Concerns: I am bothered by Am Bothered by Itching
itching.
C130535 FAC01833 FAC018-I Have Trouble Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Sleeping at Night Version 4 - Additional Concerns: I have trouble sleeping Have Trouble Sleeping at
at night. Night
C130536 FAC01834 FAC018-I Get Tired Easily Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130537 FAC01835 FAC018-I Am Losing Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130538 FAC01836 FAC018-I Have a Loss of Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Appetite Version 4 - Additional Concerns: I have a loss of appetite. Have a Loss of Appetite
C130539 FAC01837 FAC018-I Have Trouble Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Concentrating Version 4 - Additional Concerns: I have trouble Have Trouble
concentrating. Concentrating
C130540 FAC01838 FAC018-I Worry About Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Getting Infections Version 4 - Additional Concerns: I worry about getting Worry About Getting
C130541 FAC01839 FAC018-Worry I Might Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
Get New Symptoms Version 4 - Additional Concerns: I worry that I might get Worry I Might Get New
C130542 FAC01840 FAC018-Feel Isolated Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
Because of Illness Version 4 - Additional Concerns: I feel isolated from Feel Isolated Because of
C130543 FAC01841 FAC018-I Have Emotional Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Ups and Downs Version 4 - Additional Concerns: I have emotional ups Have Emotional Ups and
and downs. Downs
C130544 FAC01842 FAC018-Difficulty Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

Planning for Future Version 4 - Additional Concerns: Because of my illness, I Difficulty Planning for
have difficulty planning for the future. Future
page 526 of 1925

FAC018TN (Functional Assessment of Cancer Therapy-Lymphoma Version 4 Questionnaire Test Name)
C130256 FAC018TN
Code Value
C130531 FAC018-Bothered by FAC018-Bothered by Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

Lumps or Swelling Lumps or Swelling Version 4 - Additional Concerns: I am bothered by lumps Bothered by Lumps or
armpits, or groin).
C130507 FAC018-Bothered by FAC018-Bothered by Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

C130530 FAC018-Certain Parts of FAC018-Certain Parts of Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130529 FAC018-Content With FAC018-Content With Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130544 FAC018-Difficulty FAC018-Difficulty Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

Planning for Future Planning for Future Version 4 - Additional Concerns: Because of my illness, I Difficulty Planning for
have difficulty planning for the future. Future
C130528 FAC018-Enjoy Things I FAC018-Enjoy Things I Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130542 FAC018-Feel Isolated FAC018-Feel Isolated Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
Because of Illness Because of Illness Version 4 - Additional Concerns: I feel isolated from Feel Isolated Because of
C130511 FAC018-Get Emotional FAC018-Get Emotional Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - Get
C130525 FAC018-I Am Able to FAC018-I Am Able to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130523 FAC018-I Am Able to FAC018-I Am Able to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130532 FAC018-I Am Bothered FAC018-I Am Bothered Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
by Fevers by Fevers Version 4 - Additional Concerns: I am bothered by fevers Am Bothered by Fevers
C130534 FAC018-I Am Bothered FAC018-I Am Bothered Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
by Itching by Itching Version 4 - Additional Concerns: I am bothered by Am Bothered by Itching
itching.
C130509 FAC018-I Am Forced to FAC018-I Am Forced to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
time in bed. in Bed
C130537 FAC018-I Am Losing FAC018-I Am Losing Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130516 FAC018-I Am Satisfied FAC018-I Am Satisfied Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
my sex life. Life
C130527 FAC018-I Am Sleeping FAC018-I Am Sleeping Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130510 FAC018-I Feel Close to FAC018-I Feel Close to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
friends.
C130515 FAC018-I Feel Close to FAC018-I Feel Close to Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130508 FAC018-I Feel Ill FAC018-I Feel Ill Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130520 FAC018-I Feel Nervous FAC018-I Feel Nervous Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130517 FAC018-I Feel Sad FAC018-I Feel Sad Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
page 527 of 1925

C130256 FAC018TN
Code Value
C130512 FAC018-I Get Support FAC018-I Get Support Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
my friends. Friends
C130536 FAC018-I Get Tired Easily FAC018-I Get Tired Easily Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130503 FAC018-I Have a Lack of FAC018-I Have a Lack of Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130538 FAC018-I Have a Loss of FAC018-I Have a Loss of Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Appetite Appetite Version 4 - Additional Concerns: I have a loss of appetite. Have a Loss of Appetite
C130526 FAC018-I Have Accepted FAC018-I Have Accepted Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
illness.
C130543 FAC018-I Have Emotional FAC018-I Have Emotional Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Ups and Downs Ups and Downs Version 4 - Additional Concerns: I have emotional ups Have Emotional Ups and
and downs. Downs
C130504 FAC018-I Have Nausea FAC018-I Have Nausea Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130533 FAC018-I Have Night FAC018-I Have Night Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Sweats Sweats Version 4 - Additional Concerns: I have night sweats. Have Night Sweats
C130506 FAC018-I Have Pain FAC018-I Have Pain Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130539 FAC018-I Have Trouble FAC018-I Have Trouble Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Concentrating Concentrating Version 4 - Additional Concerns: I have trouble Have Trouble
concentrating. Concentrating
C130535 FAC018-I Have Trouble FAC018-I Have Trouble Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Sleeping at Night Sleeping at Night Version 4 - Additional Concerns: I have trouble sleeping Have Trouble Sleeping at
at night. Night
C130521 FAC018-I Worry About FAC018-I Worry About Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
C130540 FAC018-I Worry About FAC018-I Worry About Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - I
Getting Infections Getting Infections Version 4 - Additional Concerns: I worry about getting Worry About Getting
C130519 FAC018-Losing Hope FAC018-Losing Hope Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130513 FAC018-My Family Has FAC018-My Family Has Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - My
C130524 FAC018-My Work Is FAC018-My Work Is Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 - My
C130514 FAC018-Satisfied FAC018-Satisfied Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

Communication Illness Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With
Illness
C130518 FAC018-Satisfied With FAC018-Satisfied With Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130505 FAC018-Trouble Meeting FAC018-Trouble Meeting Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
C130541 FAC018-Worry I Might FAC018-Worry I Might Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -
Get New Symptoms Get New Symptoms Version 4 - Additional Concerns: I worry that I might get Worry I Might Get New
C130522 FAC018-Worry My FAC018-Worry My Functional Assessment of Cancer Therapy-Lymphoma FACT-LYM Version 4 -

page 528 of 1925

FAC023TC (The Functional Assessment of Cancer Therapy-Prostate Version 4 Questionnaire Test Code)
C127358 FAC023TC
Code Value
C127465 FAC02301 FAC023-I Have a Lack of Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Energy Version 4 - Physical Well-Being: I have a lack of energy. a Lack of Energy
C127466 FAC02302 FAC023-I Have Nausea Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Version 4 - Physical Well-Being: I have nausea. Nausea
C127467 FAC02303 FAC023-Trouble Meeting Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
C127468 FAC02304 FAC023-I Have Pain Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Version 4 - Physical Well-Being: I have pain. Pain
C127469 FAC02305 FAC023-Bothered by Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -

C127470 FAC02306 FAC023-I Feel Ill Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
C127471 FAC02307 FAC023-I Am Forced to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
time in bed. Bed
C127472 FAC02308 FAC023-I Feel Close to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
friends.
C127473 FAC02309 FAC023-Get Emotional Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Get
C127474 FAC02310 FAC023-I Get Support Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Get
my friends.
C127475 FAC02311 FAC023-My Family Has Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - My
C127476 FAC02312 FAC023-Satisfied Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -

Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With Family
C127477 FAC02313 FAC023-I Feel Close to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
C127478 FAC02314 FAC023-I Am Satisfied Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
my sex life.
C127479 FAC02315 FAC023-I Feel Sad Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
C127480 FAC02316 FAC023-Satisfied With Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
C127481 FAC02317 FAC023-Losing Hope Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Losing
Against Illness Version 4 - Emotional Well-Being: I am losing hope in the Hope Against Illness
C127482 FAC02318 FAC023-I Feel Nervous Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
C127483 FAC02319 FAC023-I Worry About Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I
C127484 FAC02320 FAC023-Worry My Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Worry
C127485 FAC02321 FAC023-I Am Able to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
page 529 of 1925

C127358 FAC023TC
Code Value
C127486 FAC02322 FAC023-My Work Is Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - My
C127487 FAC02323 FAC023-I Am Able to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
C127488 FAC02324 FAC023-I Have Accepted Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
My Illness Version 4 - Functional Well-Being: I have accepted my Accepted My Illness
illness.
C127489 FAC02325 FAC023-I Am Sleeping Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
C127490 FAC02326 FAC023-Enjoy Things I Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Enjoy
C127491 FAC02327 FAC023-Content With Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
C127492 FAC02328 FAC023-I Am Losing Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
C127493 FAC02329 FAC023-I Have a Good Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Appetite Version 4 - Additional Concerns: I have a good appetite. a Good Appetite
C127494 FAC02330 FAC023-Have Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Have
Aches/Pains That Bother Version 4 - Additional Concerns: I have aches and pains Aches and Pains That
Me that bother me. Bother Me
C127495 FAC02331 FAC023-Certain Parts of Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
my body where I experience pain. Experience Pain
C127496 FAC02332 FAC023-Pain Keeps Me Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Pain
From Doing Things Version 4 - Additional Concerns: My pain keeps me from Keeps Me From Doing
doing things I want to do. Things
C127497 FAC02333 FAC023-Satisfied With Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
Comfort Level Version 4 - Additional Concerns: I am satisfied with my Satisfied With Comfort
present comfort level. Level
C127498 FAC02334 FAC023-I Am Able to Feel Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
Like a Man Version 4 - Additional Concerns: I am able to feel like a Able to Feel Like a Man
man.
C127499 FAC02335 FAC023-I Have Trouble Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Moving My Bowels Version 4 - Additional Concerns: I have trouble moving Trouble Moving My
my bowels. Bowels
C127500 FAC02336 FAC023-I Have Difficulty Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Urinating Version 4 - Additional Concerns: I have difficulty Difficulty Urinating
urinating.
C127501 FAC02337 FAC023-I Urinate More Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I
Frequently Version 4 - Additional Concerns: I urinate more Urinate More Frequently
C127502 FAC02338 FAC023-Problem Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -

Urinating Limits Activity Version 4 - Additional Concerns: My problems with Problem Urinating Limits
urinating limit my activities. Activity
C127503 FAC02339 FAC023-Able to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Able
Have/Maintain Erection Version 4 - Additional Concerns: I am able to have and to Have and Maintain an
maintain an erection. Erection
page 530 of 1925

FAC023TN (The Functional Assessment of Cancer Therapy-Prostate Version 4 Questionnaire Test
Name)
C127357 FAC023TN
Code Value
C127503 FAC023-Able to FAC023-Able to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Able
Have/Maintain Erection Have/Maintain Erection Version 4 - Additional Concerns: I am able to have and to Have and Maintain an
maintain an erection. Erection
C127469 FAC023-Bothered by FAC023-Bothered by Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -

C127495 FAC023-Certain Parts of FAC023-Certain Parts of Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
my body where I experience pain. Experience Pain
C127491 FAC023-Content With FAC023-Content With Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
C127490 FAC023-Enjoy Things I FAC023-Enjoy Things I Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Enjoy
C127473 FAC023-Get Emotional FAC023-Get Emotional Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Get
C127494 FAC023-Have FAC023-Have Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Have
Aches/Pains That Bother Aches/Pains That Bother Version 4 - Additional Concerns: I have aches and pains Aches and Pains That
Me Me that bother me. Bother Me
C127487 FAC023-I Am Able to FAC023-I Am Able to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
C127498 FAC023-I Am Able to Feel FAC023-I Am Able to Feel Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
Like a Man Like a Man Version 4 - Additional Concerns: I am able to feel like a Able to Feel Like a Man
man.
C127485 FAC023-I Am Able to FAC023-I Am Able to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
C127471 FAC023-I Am Forced to FAC023-I Am Forced to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
time in bed. Bed
C127492 FAC023-I Am Losing FAC023-I Am Losing Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
C127478 FAC023-I Am Satisfied FAC023-I Am Satisfied Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
my sex life.
C127489 FAC023-I Am Sleeping FAC023-I Am Sleeping Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Am
C127472 FAC023-I Feel Close to FAC023-I Feel Close to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
friends.
C127477 FAC023-I Feel Close to FAC023-I Feel Close to Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
C127470 FAC023-I Feel Ill FAC023-I Feel Ill Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
C127482 FAC023-I Feel Nervous FAC023-I Feel Nervous Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
C127479 FAC023-I Feel Sad FAC023-I Feel Sad Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Feel
C127474 FAC023-I Get Support FAC023-I Get Support Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Get
my friends.
C127493 FAC023-I Have a Good FAC023-I Have a Good Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Appetite Appetite Version 4 - Additional Concerns: I have a good appetite. a Good Appetite
page 531 of 1925

C127357 FAC023TN
Code Value
C127465 FAC023-I Have a Lack of FAC023-I Have a Lack of Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Energy Energy Version 4 - Physical Well-Being: I have a lack of energy. a Lack of Energy
C127488 FAC023-I Have Accepted FAC023-I Have Accepted Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
My Illness My Illness Version 4 - Functional Well-Being: I have accepted my Accepted My Illness
illness.
C127500 FAC023-I Have Difficulty FAC023-I Have Difficulty Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Urinating Urinating Version 4 - Additional Concerns: I have difficulty Difficulty Urinating
urinating.
C127466 FAC023-I Have Nausea FAC023-I Have Nausea Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Version 4 - Physical Well-Being: I have nausea. Nausea
C127468 FAC023-I Have Pain FAC023-I Have Pain Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Version 4 - Physical Well-Being: I have pain. Pain
C127499 FAC023-I Have Trouble FAC023-I Have Trouble Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I Have
Moving My Bowels Moving My Bowels Version 4 - Additional Concerns: I have trouble moving Trouble Moving My
my bowels. Bowels
C127501 FAC023-I Urinate More FAC023-I Urinate More Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I
Frequently Frequently Version 4 - Additional Concerns: I urinate more Urinate More Frequently
C127483 FAC023-I Worry About FAC023-I Worry About Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - I
C127481 FAC023-Losing Hope FAC023-Losing Hope Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Losing
Against Illness Against Illness Version 4 - Emotional Well-Being: I am losing hope in the Hope Against Illness
C127475 FAC023-My Family Has FAC023-My Family Has Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - My
C127486 FAC023-My Work Is FAC023-My Work Is Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - My
C127496 FAC023-Pain Keeps Me FAC023-Pain Keeps Me Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Pain
From Doing Things From Doing Things Version 4 - Additional Concerns: My pain keeps me from Keeps Me From Doing
doing things I want to do. Things
C127502 FAC023-Problem FAC023-Problem Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -

Urinating Limits Activity Urinating Limits Activity Version 4 - Additional Concerns: My problems with Problem Urinating Limits
urinating limit my activities. Activity
C127476 FAC023-Satisfied FAC023-Satisfied Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -

Communication Illness Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied With Family
C127497 FAC023-Satisfied With FAC023-Satisfied With Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
Comfort Level Comfort Level Version 4 - Additional Concerns: I am satisfied with my Satisfied With Comfort
present comfort level. Level
C127480 FAC023-Satisfied With FAC023-Satisfied With Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
C127467 FAC023-Trouble Meeting FAC023-Trouble Meeting Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 -
C127484 FAC023-Worry My FAC023-Worry My Functional Assessment of Cancer Therapy-Prostate FACT-P Version 4 - Worry
page 532 of 1925

FAC028TC (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-
Bladder Symptom Index-18 Version 2 Questionnaire Test Code)
C129092 FAC028TC
Code Value
C129170 FAC02801 FAC028-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have Pain
18 Version 2 - I have pain.
C129171 FAC02802 FAC028-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Weight Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Am Losing
18 Version 2 - I am losing weight. Weight
C129172 FAC02803 FAC028-Have Trouble National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Controlling My Urine Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Have Trouble
18 Version 2 - I have trouble controlling my urine. Controlling My Urine
C129173 FAC02804 FAC028-I Feel Weak All National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Over Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Feel Weak
18 Version 2 - I feel weak all over. All Over
C129174 FAC02805 FAC028-I Feel Light- National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
headed Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Feel Light-
18 Version 2 - I feel light-headed (dizzy). headed
C129175 FAC02806 FAC028-Trouble Meeting National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Needs of Family Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Trouble
18 Version 2 - Because of my physical condition, I have Meeting Needs of Family
trouble meeting the needs of my family.
C129176 FAC02807 FAC028-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Appetite Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have a Good
18 Version 2 - I have a good appetite. Appetite
C129177 FAC02808 FAC028-Able to National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18

Have/Maintain Erection Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Able to Have,
18 Version 2 - (For men only) I am able to have and Maintain Erection
maintain an erection.
C129178 FAC02809 FAC028-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Well Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Am Sleeping
18 Version 2 - I am sleeping well. Well
C129179 FAC02810 FAC028-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18

Condition Will Get Worse Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Worry My
18 Version 2 - I worry that my condition will get worse. Condition Will Get Worse
C129180 FAC02811 FAC028-I Feel Sad National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Feel Sad
18 Version 2 - I feel sad.
C129181 FAC02812 FAC028-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have
18 Version 2 - I have nausea. Nausea
C129182 FAC02813 FAC028-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Energy Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have a Lack
18 Version 2 - I have a lack of energy. of Energy
C129183 FAC02814 FAC028-I Feel Ill National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Feel Ill
18 Version 2 - I feel ill.
C129184 FAC02815 FAC028-I Have Control of National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
My Bowels Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have Control
18 Version 2 - I have control of my bowels. of My Bowels
C129185 FAC02816 FAC028-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18

Treatment Side Effect Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Bothered by
18 Version 2 - I am bothered by side effects of treatment. Treatment Side Effect
C129186 FAC02817 FAC028-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Enjoy Life Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Am Able to
18 Version 2 - I am able to enjoy life. Enjoy Life
C129187 FAC02818 FAC028-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Quality of My Life Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Content With
18 Version 2 - I am content with the quality of my life Quality of My Life
right now.
page 533 of 1925

FAC028TN (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-
Bladder Symptom Index-18 Version 2 Questionnaire Test Name)
C129091 FAC028TN
Code Value
C129177 FAC028-Able to FAC028-Able to National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18

Have/Maintain Erection Have/Maintain Erection Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Able to Have,
18 Version 2 - (For men only) I am able to have and Maintain Erection
maintain an erection.
C129185 FAC028-Bothered by FAC028-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18

Treatment Side Effect Treatment Side Effect Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Bothered by
C129187 FAC028-Content With FAC028-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Quality of My Life Quality of My Life Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Content With
right now.
C129172 FAC028-Have Trouble FAC028-Have Trouble National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Controlling My Urine Controlling My Urine Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Have Trouble
18 Version 2 - I have trouble controlling my urine. Controlling My Urine
C129186 FAC028-I Am Able to FAC028-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Enjoy Life Enjoy Life Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Am Able to
C129171 FAC028-I Am Losing FAC028-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Weight Weight Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Am Losing
C129178 FAC028-I Am Sleeping FAC028-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Well Well Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Am Sleeping
C129183 FAC028-I Feel Ill FAC028-I Feel Ill National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Feel Ill
C129174 FAC028-I Feel Light- FAC028-I Feel Light- National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
headed headed Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Feel Light-
18 Version 2 - I feel light-headed (dizzy). headed
C129180 FAC028-I Feel Sad FAC028-I Feel Sad National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Feel Sad
18 Version 2 - I feel sad.
C129173 FAC028-I Feel Weak All FAC028-I Feel Weak All National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Over Over Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Feel Weak
C129176 FAC028-I Have a Good FAC028-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Appetite Appetite Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have a Good
C129182 FAC028-I Have a Lack of FAC028-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Energy Energy Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have a Lack
C129184 FAC028-I Have Control of FAC028-I Have Control of National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
My Bowels My Bowels Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have Control
C129181 FAC028-I Have Nausea FAC028-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have
C129170 FAC028-I Have Pain FAC028-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - I Have Pain
C129175 FAC028-Trouble Meeting FAC028-Trouble Meeting National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18
Needs of Family Needs of Family Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Trouble
18 Version 2 - Because of my physical condition, I have Meeting Needs of Family
C129179 FAC028-Worry My FAC028-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FBLSI-18

Condition Will Get Worse Condition Will Get Worse Assessment of Cancer Therapy-Bladder Symptom Index- Version 2 - Worry My
page 534 of 1925

FAC029TC (Functional Assessment of Cancer Therapy-Brain Symptom Index Questionnaire Test Code)
C138221 FAC029TC
Code Value
C138429 FAC02901 FAC029-I Get Headaches Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Get Headaches
Index - I get headaches.
C138430 FAC02902 FAC029-I Have Had Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Have Had
Seizures Index - I have had seizures (convulsions). Seizures
C138431 FAC02903 FAC029-Have Weakness Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Have Weakness
in My Arms or Legs Index - I have weakness in my arms or legs. in My Arms or Legs
C138432 FAC02904 FAC029-I Need Help in Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Need Help in
Caring for Myself Index - I need help in caring for myself (bathing, Caring for Myself
dressing, eating, etc.).
C138433 FAC02905 FAC029-I Have a Lack of Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Have a Lack of
Energy Index - I have a lack of energy. Energy
C138434 FAC02906 FAC029-Difficulty Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Difficulty
Expressing My Thoughts Index - I have difficulty expressing my thoughts. Expressing My Thoughts
C138435 FAC02907 FAC029-I Have Trouble Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Have Trouble
With Coordination Index - I have trouble with coordination. With Coordination
C138436 FAC02908 FAC029-Frustrated I Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Frustrated I
Cannot Do Things Index - I get frustrated that I cannot do things I used to. Cannot Do Things
C138437 FAC02909 FAC029-I Have Nausea Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Have Nausea
Index - I have nausea.
C138438 FAC02910 FAC029-Able to Find the Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Able to Find the
Right Words Index - I am able to find the right word(s) to say what I Right Words
mean.
C138439 FAC02911 FAC029-Losing Hope Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Losing Hope
Against Illness Index - I am losing hope in the fight against my illness. Against Illness
C138440 FAC02912 FAC029-Trouble Meeting Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Trouble Meeting
Needs of Family Index - Because of my physical condition, I have trouble Needs of Family
meeting the needs of my family.
C138441 FAC02913 FAC029-Worry My Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Worry My
Condition Will Get Worse Index - I worry that my condition will get worse. Condition Will Get Worse
C138442 FAC02914 FAC029-I Am Afraid of Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Am Afraid of
Having a Seizure Index - I am afraid of having a seizure (convulsion). Having a Seizure
C138443 FAC02915 FAC029-I Am Able to Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Am Able to
Enjoy Life Index - I am able to enjoy life. Enjoy Life
page 535 of 1925

FAC029TN (Functional Assessment of Cancer Therapy-Brain Symptom Index Questionnaire Test Name)
C138220 FAC029TN
Code Value
C138438 FAC029-Able to Find the FAC029-Able to Find the Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Able to Find the
Right Words Right Words Index - I am able to find the right word(s) to say what I Right Words
mean.
C138434 FAC029-Difficulty FAC029-Difficulty Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Difficulty
Expressing My Thoughts Expressing My Thoughts Index - I have difficulty expressing my thoughts. Expressing My Thoughts
C138436 FAC029-Frustrated I FAC029-Frustrated I Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Frustrated I
Cannot Do Things Cannot Do Things Index - I get frustrated that I cannot do things I used to. Cannot Do Things
C138431 FAC029-Have Weakness FAC029-Have Weakness Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Have Weakness
in My Arms or Legs in My Arms or Legs Index - I have weakness in my arms or legs. in My Arms or Legs
C138443 FAC029-I Am Able to FAC029-I Am Able to Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Am Able to
Enjoy Life Enjoy Life Index - I am able to enjoy life. Enjoy Life
C138442 FAC029-I Am Afraid of FAC029-I Am Afraid of Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Am Afraid of
Having a Seizure Having a Seizure Index - I am afraid of having a seizure (convulsion). Having a Seizure
C138429 FAC029-I Get Headaches FAC029-I Get Headaches Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Get Headaches
Index - I get headaches.
C138433 FAC029-I Have a Lack of FAC029-I Have a Lack of Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Have a Lack of
Energy Energy Index - I have a lack of energy. Energy
C138430 FAC029-I Have Had FAC029-I Have Had Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Have Had
Seizures Seizures Index - I have had seizures (convulsions). Seizures
C138437 FAC029-I Have Nausea FAC029-I Have Nausea Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Have Nausea
Index - I have nausea.
C138435 FAC029-I Have Trouble FAC029-I Have Trouble Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Have Trouble
With Coordination With Coordination Index - I have trouble with coordination. With Coordination
C138432 FAC029-I Need Help in FAC029-I Need Help in Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - I Need Help in
Caring for Myself Caring for Myself Index - I need help in caring for myself (bathing, Caring for Myself
C138439 FAC029-Losing Hope FAC029-Losing Hope Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Losing Hope
Against Illness Against Illness Index - I am losing hope in the fight against my illness. Against Illness
C138440 FAC029-Trouble Meeting FAC029-Trouble Meeting Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Trouble Meeting
Needs of Family Needs of Family Index - Because of my physical condition, I have trouble Needs of Family
C138441 FAC029-Worry My FAC029-Worry My Functional Assessment of Cancer Therapy-Brain Symptom FBRSI - Worry My
Condition Will Get Worse Condition Will Get Worse Index - I worry that my condition will get worse. Condition Will Get Worse
page 536 of 1925

FAC030TC (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-Brain
Symptom Index-24 Version 2 Questionnaire Test Code)
C150786 FAC030TC
Code Value
C151280 FAC03001 FAC030-I Get Headaches National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Get
Version 2 - I get headaches. Headaches
C151281 FAC03002 FAC030-I Have Trouble National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
With Coordination Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have
Version 2 - I have trouble with coordination. Trouble With Coordination
C151282 FAC03003 FAC030-I Have Had National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Seizures Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have Had
Version 2 - I have had seizures (convulsions). Seizures
C151283 FAC03004 FAC030-I Need Help in National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Caring for Myself Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Need Help in
Version 2 - I need help in caring for myself (bathing, Caring for Myself
C151284 FAC03005 FAC030-Have Weakness National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
in My Arms or Legs Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Have
Version 2 - I have weakness in my arms or legs. Weakness in My Arms or
Legs
C151285 FAC03006 FAC030-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Weight Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Losing
Version 2 - I am losing weight. Weight
C151286 FAC03007 FAC030-Trouble Meeting National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Needs of Family Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Trouble
Version 2 - Because of my physical condition, I have Meeting Needs of Family
C151287 FAC03008 FAC030-Difficulty National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Expressing My Thoughts Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Difficulty
Version 2 - I have difficulty expressing my thoughts. Expressing My Thoughts
C151288 FAC03009 FAC030-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Well Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Sleeping
Version 2 - I am sleeping well. Well
C151289 FAC03010 FAC030-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Concentrate Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Able to
Version 2 - I am able to concentrate. Concentrate
C151290 FAC03011 FAC030-I Can Remember National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
New Things Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Can
Version 2 - I can remember new things. Remember New Things
C151291 FAC03012 FAC030-Able to Find the National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Right Words Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Able to Find
Version 2 - I am able to find the right word(s) to say the Right Words
what I mean.
C151292 FAC03013 FAC030-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Change in Personality Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Bothered by
Version 2 - I am bothered by the change in my Change in Personality
personality.
C151293 FAC03014 FAC030-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Condition Will Get Worse Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Worry My
Version 2 - I worry that my condition will get worse. Condition Will Get Worse
C151294 FAC03015 FAC030-I Am Afraid of National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Having a Seizure Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Afraid of
Version 2 - I am afraid of having a seizure (convulsion). Having a Seizure
C151295 FAC03016 FAC030-Frustrated I National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Cannot Do Things Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Frustrated I
Version 2 - I get frustrated that I cannot do things I used Cannot Do Things
to.
C151296 FAC03017 FAC030-Losing Hope National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Against Illness Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Losing Hope
Version 2 - I am losing hope in the fight against my Against Illness
illness.
C151297 FAC03018 FAC030-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Energy Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have a Lack
Version 2 - I have a lack of energy. of Energy
page 537 of 1925

C150786 FAC030TC
Code Value
C151298 FAC03019 FAC030-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have
Version 2 - I have nausea. Nausea
C151299 FAC03020 FAC030-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Treatment Side Effect Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Bothered by
Version 2 - I am bothered by side effects of treatment. Treatment Side Effect
C151300 FAC03021 FAC030-I Feel Fatigued National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Feel
Version 2 - I feel fatigued. Fatigued
C151301 FAC03022 FAC030-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Appetite Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have a Good
Version 2 - I have a good appetite. Appetite
C151302 FAC03023 FAC030-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Enjoy Life Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Able to
Version 2 - I am able to enjoy life. Enjoy Life
C151303 FAC03024 FAC030-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Quality of My Life Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Content With
Version 2 - I am content with the quality of my life right Quality of My Life
now.
page 538 of 1925

FAC030TN (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-Brain
Symptom Index-24 Version 2 Questionnaire Test Name)
C150785 FAC030TN
Code Value
C151291 FAC030-Able to Find the FAC030-Able to Find the National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Right Words Right Words Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Able to Find
Version 2 - I am able to find the right word(s) to say the Right Words
what I mean.
C151292 FAC030-Bothered by FAC030-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Change in Personality Change in Personality Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Bothered by
Version 2 - I am bothered by the change in my Change in Personality
personality.
C151299 FAC030-Bothered by FAC030-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Treatment Side Effect Treatment Side Effect Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Bothered by
Version 2 - I am bothered by side effects of treatment. Treatment Side Effect
C151303 FAC030-Content With FAC030-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Quality of My Life Quality of My Life Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Content With
Version 2 - I am content with the quality of my life right Quality of My Life
now.
C151287 FAC030-Difficulty FAC030-Difficulty National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Expressing My Thoughts Expressing My Thoughts Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Difficulty
Version 2 - I have difficulty expressing my thoughts. Expressing My Thoughts
C151295 FAC030-Frustrated I FAC030-Frustrated I National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Cannot Do Things Cannot Do Things Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Frustrated I
Version 2 - I get frustrated that I cannot do things I used Cannot Do Things
to.
C151284 FAC030-Have Weakness FAC030-Have Weakness National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
in My Arms or Legs in My Arms or Legs Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Have
Version 2 - I have weakness in my arms or legs. Weakness in My Arms or
Legs
C151289 FAC030-I Am Able to FAC030-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Concentrate Concentrate Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Able to
Version 2 - I am able to concentrate. Concentrate
C151302 FAC030-I Am Able to FAC030-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Enjoy Life Enjoy Life Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Able to
Version 2 - I am able to enjoy life. Enjoy Life
C151294 FAC030-I Am Afraid of FAC030-I Am Afraid of National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Having a Seizure Having a Seizure Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Afraid of
Version 2 - I am afraid of having a seizure (convulsion). Having a Seizure
C151285 FAC030-I Am Losing FAC030-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Weight Weight Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Losing
Version 2 - I am losing weight. Weight
C151288 FAC030-I Am Sleeping FAC030-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Well Well Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Am Sleeping
Version 2 - I am sleeping well. Well
C151290 FAC030-I Can Remember FAC030-I Can Remember National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
New Things New Things Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Can
Version 2 - I can remember new things. Remember New Things
C151300 FAC030-I Feel Fatigued FAC030-I Feel Fatigued National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Feel
Version 2 - I feel fatigued. Fatigued
C151280 FAC030-I Get Headaches FAC030-I Get Headaches National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Get
Version 2 - I get headaches. Headaches
C151301 FAC030-I Have a Good FAC030-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Appetite Appetite Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have a Good
Version 2 - I have a good appetite. Appetite
C151297 FAC030-I Have a Lack of FAC030-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Energy Energy Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have a Lack
Version 2 - I have a lack of energy. of Energy
C151282 FAC030-I Have Had FAC030-I Have Had National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Seizures Seizures Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have Had
Version 2 - I have had seizures (convulsions). Seizures
page 539 of 1925

C150785 FAC030TN
Code Value
C151298 FAC030-I Have Nausea FAC030-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have
Version 2 - I have nausea. Nausea
C151281 FAC030-I Have Trouble FAC030-I Have Trouble National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
With Coordination With Coordination Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Have
Version 2 - I have trouble with coordination. Trouble With Coordination
C151283 FAC030-I Need Help in FAC030-I Need Help in National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Caring for Myself Caring for Myself Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - I Need Help in
Version 2 - I need help in caring for myself (bathing, Caring for Myself
C151296 FAC030-Losing Hope FAC030-Losing Hope National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Against Illness Against Illness Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Losing Hope
Version 2 - I am losing hope in the fight against my Against Illness
illness.
C151286 FAC030-Trouble Meeting FAC030-Trouble Meeting National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24
Needs of Family Needs of Family Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Trouble
Version 2 - Because of my physical condition, I have Meeting Needs of Family
C151293 FAC030-Worry My FAC030-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FBRSI-24

Condition Will Get Worse Condition Will Get Worse Assessment of Cancer Therapy-Brain Symptom Index-24 Version 2 - Worry My
Version 2 - I worry that my condition will get worse. Condition Will Get Worse
page 540 of 1925

FAC036TC (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-Head
& Neck Symptom Index-22 Version 2 Questionnaire Test Code)
C150788 FAC036TC
Code Value
C151304 FAC03601 FAC036-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have Pain
Index-22 Version 2 - I have pain.
C151305 FAC03602 FAC036-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Weight Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am Losing
Index-22 Version 2 - I am losing weight. Weight
C151306 FAC03603 FAC036-I Have Trouble National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Breathing Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have
Index-22 Version 2 - I have trouble breathing. Trouble Breathing
C151307 FAC03604 FAC036-I Feel Ill National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Feel Ill
Index-22 Version 2 - I feel ill.
C151308 FAC03605 FAC036-Pain in My National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22

Mouth, Throat or Neck Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Pain in My
Index-22 Version 2 - I have pain in my mouth, throat or Mouth, Throat or Neck
neck.
C151309 FAC03606 FAC036-Trouble Meeting National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Needs of Family Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Trouble
Index-22 Version 2 - Because of my physical condition, I Meeting Needs of Family
have trouble meeting the needs of my family.
C151310 FAC03607 FAC036-Can Swallow National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Naturally and Easily Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Can Swallow
Index-22 Version 2 - I can swallow naturally and easily. Naturally and Easily
C151311 FAC03608 FAC036-Able to Eat the National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Foods That I Like Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Able to Eat
Index-22 Version 2 - I am able to eat the foods that I the Foods That I Like
like.
C151312 FAC03609 FAC036-Able to National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22

Communicate With Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Able to
Others Index-22 Version 2 - I am able to communicate with Communicate With
others. Others
C151313 FAC03610 FAC036-I Can Eat Solid National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Foods Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Can Eat
Index-22 Version 2 - I can eat solid foods. Solid Foods
C151314 FAC03611 FAC036-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Well Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am Sleeping
Index-22 Version 2 - I am sleeping well. Well
C151315 FAC03612 FAC036-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22

Condition Will Get Worse Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Worry My
Index-22 Version 2 - I worry that my condition will get Condition Will Get Worse
worse.
C151316 FAC03613 FAC036-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Energy Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have a Lack
Index-22 Version 2 - I have a lack of energy. of Energy
C151317 FAC03614 FAC036-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have
Index-22 Version 2 - I have nausea. Nausea
C151318 FAC03615 FAC036-Had Change in National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
the Way Food Tastes Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Had Change
Index-22 Version 2 - I have had a change in the way food in the Way Food Tastes
tastes.
C151319 FAC03616 FAC036-I Have Mouth National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Sores Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have Mouth
Index-22 Version 2 - I have mouth sores. Sores
C151320 FAC03617 FAC036-I Am Bothered National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
by Hair Loss Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am
Index-22 Version 2 - I am bothered by hair loss. Bothered by Hair Loss
C151321 FAC03618 FAC036-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22

Treatment Side Effect Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Bothered by
Index-22 Version 2 - I am bothered by side effects of Treatment Side Effect
treatment.
page 541 of 1925

C150788 FAC036TC
Code Value
C151322 FAC03619 FAC036-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Appetite Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have a Good
Index-22 Version 2 - I have a good appetite. Appetite
C151323 FAC03620 FAC036-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Work Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am Able to
Index-22 Version 2 - I am able to work (include work at Work
home).
C151324 FAC03621 FAC036-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Enjoy Life Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am Able to
Index-22 Version 2 - I am able to enjoy life. Enjoy Life
C151325 FAC03622 FAC036-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Quality of My Life Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Content With
Index-22 Version 2 - I am content with the quality of my Quality of My Life
life right now.
page 542 of 1925

FAC036TN (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-Head
& Neck Symptom Index-22 Version 2 Questionnaire Test Name)
C150787 FAC036TN
Code Value
C151312 FAC036-Able to FAC036-Able to National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22

Communicate With Communicate With Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Able to
Others Others Index-22 Version 2 - I am able to communicate with Communicate With
others. Others
C151311 FAC036-Able to Eat the FAC036-Able to Eat the National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Foods That I Like Foods That I Like Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Able to Eat
Index-22 Version 2 - I am able to eat the foods that I the Foods That I Like
like.
C151321 FAC036-Bothered by FAC036-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22

Treatment Side Effect Treatment Side Effect Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Bothered by
Index-22 Version 2 - I am bothered by side effects of Treatment Side Effect
treatment.
C151310 FAC036-Can Swallow FAC036-Can Swallow National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Naturally and Easily Naturally and Easily Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Can Swallow
Index-22 Version 2 - I can swallow naturally and easily. Naturally and Easily
C151325 FAC036-Content With FAC036-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Quality of My Life Quality of My Life Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Content With
Index-22 Version 2 - I am content with the quality of my Quality of My Life
life right now.
C151318 FAC036-Had Change in FAC036-Had Change in National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
the Way Food Tastes the Way Food Tastes Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Had Change
Index-22 Version 2 - I have had a change in the way food in the Way Food Tastes
tastes.
C151324 FAC036-I Am Able to FAC036-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Enjoy Life Enjoy Life Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am Able to
Index-22 Version 2 - I am able to enjoy life. Enjoy Life
C151323 FAC036-I Am Able to FAC036-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Work Work Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am Able to
Index-22 Version 2 - I am able to work (include work at Work
home).
C151320 FAC036-I Am Bothered FAC036-I Am Bothered National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
by Hair Loss by Hair Loss Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am
Index-22 Version 2 - I am bothered by hair loss. Bothered by Hair Loss
C151305 FAC036-I Am Losing FAC036-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Weight Weight Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am Losing
Index-22 Version 2 - I am losing weight. Weight
C151314 FAC036-I Am Sleeping FAC036-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Well Well Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Am Sleeping
Index-22 Version 2 - I am sleeping well. Well
C151313 FAC036-I Can Eat Solid FAC036-I Can Eat Solid National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Foods Foods Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Can Eat
Index-22 Version 2 - I can eat solid foods. Solid Foods
C151307 FAC036-I Feel Ill FAC036-I Feel Ill National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Feel Ill
Index-22 Version 2 - I feel ill.
C151322 FAC036-I Have a Good FAC036-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Appetite Appetite Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have a Good
Index-22 Version 2 - I have a good appetite. Appetite
C151316 FAC036-I Have a Lack of FAC036-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Energy Energy Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have a Lack
Index-22 Version 2 - I have a lack of energy. of Energy
C151319 FAC036-I Have Mouth FAC036-I Have Mouth National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Sores Sores Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have Mouth
Index-22 Version 2 - I have mouth sores. Sores
C151317 FAC036-I Have Nausea FAC036-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have
Index-22 Version 2 - I have nausea. Nausea
C151304 FAC036-I Have Pain FAC036-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have Pain
Index-22 Version 2 - I have pain.
page 543 of 1925

C150787 FAC036TN
Code Value
C151306 FAC036-I Have Trouble FAC036-I Have Trouble National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Breathing Breathing Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - I Have
Index-22 Version 2 - I have trouble breathing. Trouble Breathing
C151308 FAC036-Pain in My FAC036-Pain in My National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22

Mouth, Throat or Neck Mouth, Throat or Neck Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Pain in My
Index-22 Version 2 - I have pain in my mouth, throat or Mouth, Throat or Neck
neck.
C151309 FAC036-Trouble Meeting FAC036-Trouble Meeting National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22
Needs of Family Needs of Family Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Trouble
Index-22 Version 2 - Because of my physical condition, I Meeting Needs of Family
have trouble meeting the needs of my family.
C151315 FAC036-Worry My FAC036-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FHNSI-22

Condition Will Get Worse Condition Will Get Worse Assessment of Cancer Therapy-Head & Neck Symptom Version 2 - Worry My
Index-22 Version 2 - I worry that my condition will get Condition Will Get Worse
worse.
page 544 of 1925

FAC039TC (Functional Assessment of Cancer Therapy-Kidney Symptom Index-15 Questionnaire Test
Code)
C138223 FAC039TC
Code Value
C138444 FAC03901 FAC039-I Have a Lack of Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have a Lack
Energy Symptom Index-15 - I have a lack of energy. of Energy
C138445 FAC03902 FAC039-Bothered by Functional Assessment of Cancer Therapy-Kidney FKSI-15 - Bothered by

Treatment Side Effect Symptom Index-15 - I am bothered by side effects of Treatment Side Effect
treatment.
C138446 FAC03903 FAC039-I Have Pain Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Pain
Symptom Index-15 - I have pain.
C138447 FAC03904 FAC039-I Am Losing Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Losing
Weight Symptom Index-15 - I am losing weight. Weight
C138448 FAC03905 FAC039-I Have Bone Pain Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Bone
Symptom Index-15 - I have bone pain. Pain
C138449 FAC03906 FAC039-I Feel Fatigued Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Feel Fatigued
Symptom Index-15 - I feel fatigued.
C138450 FAC03907 FAC039-I Am Able to Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Able to
Enjoy Life Symptom Index-15 - I am able to enjoy life. Enjoy Life
C138451 FAC03908 FAC039-I Have Been Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Been
Short of Breath Symptom Index-15 - I have been short of breath. Short of Breath
C138452 FAC03909 FAC039-Worry My Functional Assessment of Cancer Therapy-Kidney FKSI-15 - Worry My

Condition Will Get Worse Symptom Index-15 - I worry that my condition will get Condition Will Get Worse
worse.
C138453 FAC03910 FAC039-I Have a Good Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have a Good
Appetite Symptom Index-15 - I have a good appetite. Appetite
C138454 FAC03911 FAC039-I Have Been Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Been
Coughing Symptom Index-15 - I have been coughing. Coughing
C138455 FAC03912 FAC039-I Am Bothered Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Bothered
by Fevers Symptom Index-15 - I am bothered by fevers (episodes by Fevers
of high body temperature).
C138456 FAC03913 FAC039-I Am Able to Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Able to
Work Symptom Index-15 - I am able to work (include work at Work
home).
C138457 FAC03914 FAC039-I Have Had Blood Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Had
in My Urine Symptom Index-15 - I have had blood in my urine. Blood in My Urine
C138458 FAC03915 FAC039-I Am Sleeping Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Sleeping
Well Symptom Index-15 - I am sleeping well. Well
page 545 of 1925

FAC039TN (Functional Assessment of Cancer Therapy-Kidney Symptom Index-15 Questionnaire Test
Name)
C138222 FAC039TN
Code Value
C138445 FAC039-Bothered by FAC039-Bothered by Functional Assessment of Cancer Therapy-Kidney FKSI-15 - Bothered by

Treatment Side Effect Treatment Side Effect Symptom Index-15 - I am bothered by side effects of Treatment Side Effect
treatment.
C138450 FAC039-I Am Able to FAC039-I Am Able to Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Able to
Enjoy Life Enjoy Life Symptom Index-15 - I am able to enjoy life. Enjoy Life
C138456 FAC039-I Am Able to FAC039-I Am Able to Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Able to
Work Work Symptom Index-15 - I am able to work (include work at Work
home).
C138455 FAC039-I Am Bothered FAC039-I Am Bothered Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Bothered
by Fevers by Fevers Symptom Index-15 - I am bothered by fevers (episodes by Fevers
of high body temperature).
C138447 FAC039-I Am Losing FAC039-I Am Losing Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Losing
Weight Weight Symptom Index-15 - I am losing weight. Weight
C138458 FAC039-I Am Sleeping FAC039-I Am Sleeping Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Am Sleeping
Well Well Symptom Index-15 - I am sleeping well. Well
C138449 FAC039-I Feel Fatigued FAC039-I Feel Fatigued Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Feel Fatigued
Symptom Index-15 - I feel fatigued.
C138453 FAC039-I Have a Good FAC039-I Have a Good Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have a Good
Appetite Appetite Symptom Index-15 - I have a good appetite. Appetite
C138444 FAC039-I Have a Lack of FAC039-I Have a Lack of Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have a Lack
Energy Energy Symptom Index-15 - I have a lack of energy. of Energy
C138454 FAC039-I Have Been FAC039-I Have Been Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Been
Coughing Coughing Symptom Index-15 - I have been coughing. Coughing
C138451 FAC039-I Have Been FAC039-I Have Been Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Been
Short of Breath Short of Breath Symptom Index-15 - I have been short of breath. Short of Breath
C138448 FAC039-I Have Bone Pain FAC039-I Have Bone Pain Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Bone
Symptom Index-15 - I have bone pain. Pain
C138457 FAC039-I Have Had Blood FAC039-I Have Had Blood Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Had
in My Urine in My Urine Symptom Index-15 - I have had blood in my urine. Blood in My Urine
C138446 FAC039-I Have Pain FAC039-I Have Pain Functional Assessment of Cancer Therapy-Kidney FKSI-15 - I Have Pain
Symptom Index-15 - I have pain.
C138452 FAC039-Worry My FAC039-Worry My Functional Assessment of Cancer Therapy-Kidney FKSI-15 - Worry My

Condition Will Get Worse Condition Will Get Worse Symptom Index-15 - I worry that my condition will get Condition Will Get Worse
worse.
page 546 of 1925

FAC041TC (Functional Assessment of Cancer Therapy-Kidney Symptom Index-Disease-Related
Symptoms Version 4 Questionnaire Test Code)
C150784 FAC041TC
Code Value
C151271 FAC04101 FAC041-I Have a Lack of Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Energy Symptom Index-Disease-Related Symptoms Version 4 - I Have a Lack of Energy
have a lack of energy.
C151272 FAC04102 FAC041-I Have Pain Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Symptom Index-Disease-Related Symptoms Version 4 - I Have Pain
have pain.
C151273 FAC04103 FAC041-I Am Losing Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Weight Symptom Index-Disease-Related Symptoms Version 4 - I Am Losing Weight
am losing weight.
C151274 FAC04104 FAC041-I Have Bone Pain Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Symptom Index-Disease-Related Symptoms Version 4 - I Have Bone Pain
have bone pain.
C151275 FAC04105 FAC041-I Feel Fatigued Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Symptom Index-Disease-Related Symptoms Version 4 - I Feel Fatigued
feel fatigued.
C151276 FAC04106 FAC041-I Have Been Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Short of Breath Symptom Index-Disease-Related Symptoms Version 4 - I Have Been Short of
have been short of breath. Breath
C151277 FAC04107 FAC041-I Have Been Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Coughing Symptom Index-Disease-Related Symptoms Version 4 - I Have Been Coughing
have been coughing.
C151278 FAC04108 FAC041-I Am Bothered Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
by Fevers Symptom Index-Disease-Related Symptoms Version 4 - I Am Bothered by Fevers
am bothered by fevers (episodes of high body
temperature).
C151279 FAC04109 FAC041-I Have Had Blood Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
in My Urine Symptom Index-Disease-Related Symptoms Version 4 - I Have Had Blood in My
have had blood in my urine. Urine
page 547 of 1925

FAC041TN (Functional Assessment of Cancer Therapy-Kidney Symptom Index-Disease-Related
Symptoms Version 4 Questionnaire Test Name)
C150783 FAC041TN
Code Value
C151278 FAC041-I Am Bothered FAC041-I Am Bothered Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
by Fevers by Fevers Symptom Index-Disease-Related Symptoms Version 4 - I Am Bothered by Fevers
am bothered by fevers (episodes of high body
temperature).
C151273 FAC041-I Am Losing FAC041-I Am Losing Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Weight Weight Symptom Index-Disease-Related Symptoms Version 4 - I Am Losing Weight
am losing weight.
C151275 FAC041-I Feel Fatigued FAC041-I Feel Fatigued Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Symptom Index-Disease-Related Symptoms Version 4 - I Feel Fatigued
feel fatigued.
C151271 FAC041-I Have a Lack of FAC041-I Have a Lack of Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Energy Energy Symptom Index-Disease-Related Symptoms Version 4 - I Have a Lack of Energy
C151277 FAC041-I Have Been FAC041-I Have Been Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Coughing Coughing Symptom Index-Disease-Related Symptoms Version 4 - I Have Been Coughing
have been coughing.
C151276 FAC041-I Have Been FAC041-I Have Been Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Short of Breath Short of Breath Symptom Index-Disease-Related Symptoms Version 4 - I Have Been Short of
have been short of breath. Breath
C151274 FAC041-I Have Bone Pain FAC041-I Have Bone Pain Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Symptom Index-Disease-Related Symptoms Version 4 - I Have Bone Pain
have bone pain.
C151279 FAC041-I Have Had Blood FAC041-I Have Had Blood Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
in My Urine in My Urine Symptom Index-Disease-Related Symptoms Version 4 - I Have Had Blood in My
have had blood in my urine. Urine
C151272 FAC041-I Have Pain FAC041-I Have Pain Functional Assessment of Cancer Therapy-Kidney FKSI-DRS Version 4 - I
Symptom Index-Disease-Related Symptoms Version 4 - I Have Pain
have pain.
page 548 of 1925

FAC042TC (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-Kidney
Symptom Index-19 Version 2 Questionnaire Test Code)
C129090 FAC042TC
Code Value
C129151 FAC04201 FAC042-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Energy Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have a Lack
C129152 FAC04202 FAC042-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Pain
C129153 FAC04203 FAC042-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Weight Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am Losing
C129154 FAC04204 FAC042-I Feel Fatigued National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Feel
19 Version 2 - I feel fatigued. Fatigued
C129155 FAC04205 FAC042-I Have Been National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Short of Breath Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Been
19 Version 2 - I have been short of breath. Short of Breath
C129156 FAC04206 FAC042-I Am Bothered National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
by Fevers Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am
19 Version 2 - I am bothered by fevers (episodes of high Bothered by Fevers
body temperature).
C129157 FAC04207 FAC042-I Have Bone Pain National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Bone
19 Version 2 - I have bone pain. Pain
C129158 FAC04208 FAC042-I Have Been National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Coughing Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Been
19 Version 2 - I have been coughing. Coughing
C129159 FAC04209 FAC042-I Feel Weak All National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Over Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Feel Weak
C129160 FAC04210 FAC042-I Have Had Blood National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
in My Urine Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Had
19 Version 2 - I have had blood in my urine. Blood in My Urine
C129161 FAC04211 FAC042-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Appetite Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have a Good
C129162 FAC04212 FAC042-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Well Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am Sleeping
C129163 FAC04213 FAC042-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19

Condition Will Get Worse Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - Worry My
C129164 FAC04214 FAC042-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have
C129165 FAC04215 FAC042-I Have Diarrhea National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
19 Version 2 - I have diarrhea (diarrhoea). Diarrhea
C129166 FAC04216 FAC042-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19

Treatment Side Effect Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - Bothered by
C129167 FAC04217 FAC042-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Work Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am Able to
19 Version 2 - I am able to work (include work at home). Work
C129168 FAC04218 FAC042-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Enjoy Life Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am Able to
C129169 FAC04219 FAC042-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Quality of My Life Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - Content With
right now.
page 549 of 1925

Kidney Symptom Index-19 Version 2 Questionnaire Test Name)
C129089 FAC042TN
Code Value
C129166 FAC042-Bothered by FAC042-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19

Treatment Side Effect Treatment Side Effect Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - Bothered by
C129169 FAC042-Content With FAC042-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Quality of My Life Quality of My Life Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - Content With
right now.
C129168 FAC042-I Am Able to FAC042-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Enjoy Life Enjoy Life Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am Able to
C129167 FAC042-I Am Able to FAC042-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Work Work Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am Able to
19 Version 2 - I am able to work (include work at home). Work
C129156 FAC042-I Am Bothered FAC042-I Am Bothered National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
by Fevers by Fevers Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am
19 Version 2 - I am bothered by fevers (episodes of high Bothered by Fevers
body temperature).
C129153 FAC042-I Am Losing FAC042-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Weight Weight Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am Losing
C129162 FAC042-I Am Sleeping FAC042-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Well Well Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Am Sleeping
C129154 FAC042-I Feel Fatigued FAC042-I Feel Fatigued National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Feel
C129159 FAC042-I Feel Weak All FAC042-I Feel Weak All National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Over Over Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Feel Weak
C129161 FAC042-I Have a Good FAC042-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Appetite Appetite Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have a Good
C129151 FAC042-I Have a Lack of FAC042-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Energy Energy Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have a Lack
C129158 FAC042-I Have Been FAC042-I Have Been National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Coughing Coughing Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Been
19 Version 2 - I have been coughing. Coughing
C129155 FAC042-I Have Been FAC042-I Have Been National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Short of Breath Short of Breath Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Been
19 Version 2 - I have been short of breath. Short of Breath
C129157 FAC042-I Have Bone Pain FAC042-I Have Bone Pain National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Bone
C129165 FAC042-I Have Diarrhea FAC042-I Have Diarrhea National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
19 Version 2 - I have diarrhea (diarrhoea). Diarrhea
C129160 FAC042-I Have Had Blood FAC042-I Have Had Blood National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
in My Urine in My Urine Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Had
19 Version 2 - I have had blood in my urine. Blood in My Urine
C129164 FAC042-I Have Nausea FAC042-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
C129152 FAC042-I Have Pain FAC042-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19
Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - I Have Pain
C129163 FAC042-Worry My FAC042-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FKSI-19

Condition Will Get Worse Condition Will Get Worse Assessment of Cancer Therapy-Kidney Symptom Index- Version 2 - Worry My
page 550 of 1925

FAC043TC (Functional Assessment of Cancer Therapy-Lung Symptom Index Questionnaire Test Code)
C138225 FAC043TC
Code Value
C138459 FAC04301 FAC043-I Have Been Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Have Been Short
Short of Breath Index - I have been short of breath. of Breath
C138460 FAC04302 FAC043-I Have a Lack of Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Have a Lack of
Energy Index - I have a lack of energy. Energy
C138461 FAC04303 FAC043-I Have Pain Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Have Pain
Index - I have pain.
C138462 FAC04304 FAC043-I Am Losing Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Am Losing
Weight Index - I am losing weight. Weight
C138463 FAC04305 FAC043-I Have Been Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Have Been
Coughing Index - I have been coughing. Coughing
C138464 FAC04306 FAC043-Certain Parts of Functional Assessment of Cancer Therapy-Lung Symptom FLSI - Certain Parts of
Body Have Pain Index - I have certain parts of my body where I Body Have Pain
experience pain.
page 551 of 1925

FAC043TN (Functional Assessment of Cancer Therapy-Lung Symptom Index Questionnaire Test Name)
C138224 FAC043TN
Code Value
C138464 FAC043-Certain Parts of FAC043-Certain Parts of Functional Assessment of Cancer Therapy-Lung Symptom FLSI - Certain Parts of
Body Have Pain Body Have Pain Index - I have certain parts of my body where I Body Have Pain
experience pain.
C138462 FAC043-I Am Losing FAC043-I Am Losing Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Am Losing
Weight Weight Index - I am losing weight. Weight
C138460 FAC043-I Have a Lack of FAC043-I Have a Lack of Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Have a Lack of
Energy Energy Index - I have a lack of energy. Energy
C138463 FAC043-I Have Been FAC043-I Have Been Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Have Been
Coughing Coughing Index - I have been coughing. Coughing
C138459 FAC043-I Have Been FAC043-I Have Been Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Have Been Short
Short of Breath Short of Breath Index - I have been short of breath. of Breath
C138461 FAC043-I Have Pain FAC043-I Have Pain Functional Assessment of Cancer Therapy-Lung Symptom FLSI - I Have Pain
Index - I have pain.
page 552 of 1925

FAC049TC (Functional Assessment of Cancer Therapy-Ovarian Symptom Index Questionnaire Test
Code)
C129096 FAC049TC
Code Value
C129225 FAC04901 FAC049-I Have a Lack of Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have a Lack of
Energy Symptom Index - I have a lack of energy. Energy
C129226 FAC04902 FAC049-I Have Been Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Been
Vomiting Symptom Index - I have been vomiting. Vomiting
C129227 FAC04903 FAC049-I Have Pain Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Pain
Symptom Index - I have pain.
C129228 FAC04904 FAC049-I Have Nausea Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Nausea
Symptom Index - I have nausea.
C129229 FAC04905 FAC049-I Have Swelling Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Swelling in
in Stomach Area Symptom Index - I have swelling in my stomach area. Stomach Area
C129230 FAC04906 FAC049-Worry My Functional Assessment of Cancer Therapy-Ovarian FOSI - Worry My

Condition Will Get Worse Symptom Index - I worry that my condition will get Condition Will Get Worse
worse.
C129231 FAC04907 FAC049-Content With Functional Assessment of Cancer Therapy-Ovarian FOSI - Content With
Quality of My Life Symptom Index - I am content with the quality of my life Quality of My Life
right now.
C129232 FAC04908 FAC049-I Have Cramps in Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Cramps in
My Stomach Area Symptom Index - I have cramps in my stomach area. My Stomach Area
page 553 of 1925

FAC049TN (Functional Assessment of Cancer Therapy-Ovarian Symptom Index Questionnaire Test
Name)
C129095 FAC049TN
Code Value
C129231 FAC049-Content With FAC049-Content With Functional Assessment of Cancer Therapy-Ovarian FOSI - Content With
Quality of My Life Quality of My Life Symptom Index - I am content with the quality of my life Quality of My Life
right now.
C129225 FAC049-I Have a Lack of FAC049-I Have a Lack of Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have a Lack of
Energy Energy Symptom Index - I have a lack of energy. Energy
C129226 FAC049-I Have Been FAC049-I Have Been Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Been
Vomiting Vomiting Symptom Index - I have been vomiting. Vomiting
C129232 FAC049-I Have Cramps in FAC049-I Have Cramps in Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Cramps in
My Stomach Area My Stomach Area Symptom Index - I have cramps in my stomach area. My Stomach Area
C129228 FAC049-I Have Nausea FAC049-I Have Nausea Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Nausea
Symptom Index - I have nausea.
C129227 FAC049-I Have Pain FAC049-I Have Pain Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Pain
Symptom Index - I have pain.
C129229 FAC049-I Have Swelling FAC049-I Have Swelling Functional Assessment of Cancer Therapy-Ovarian FOSI - I Have Swelling in
in Stomach Area in Stomach Area Symptom Index - I have swelling in my stomach area. Stomach Area
C129230 FAC049-Worry My FAC049-Worry My Functional Assessment of Cancer Therapy-Ovarian FOSI - Worry My

Condition Will Get Worse Condition Will Get Worse Symptom Index - I worry that my condition will get Condition Will Get Worse
worse.
page 554 of 1925

FAC050TC (National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-
Ovarian Symptom Index-18 Version 2 Questionnaire Test Code)
C129098 FAC050TC
Code Value
C129233 FAC05001 FAC050-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Energy Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have a Lack
C129234 FAC05002 FAC050-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have Pain
C129235 FAC05003 FAC050-I Feel Ill National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Feel Ill
C129236 FAC05004 FAC050-I Have Cramps in National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
My Stomach Area Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have
18 Version 2 - I have cramps in my stomach area. Cramps in My Stomach
Area
C129237 FAC05005 FAC050-I Feel Fatigued National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Feel
C129238 FAC05006 FAC050-I Am Bothered National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
by Constipation Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am
18 Version 2 - I am bothered by constipation. Bothered by Constipation
C129239 FAC05007 FAC050-I Have Swelling National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
in Stomach Area Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have
18 Version 2 - I have swelling in my stomach area. Swelling in Stomach Area
C129240 FAC05008 FAC050-I Have Control of National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
My Bowels Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have Control
C129241 FAC05009 FAC050-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Well Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am Sleeping
C129242 FAC05010 FAC050-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18

Condition Will Get Worse Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - Worry My
C129243 FAC05011 FAC050-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have
by Hair Loss Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am
18 Version 2 - I am bothered by hair loss. Bothered by Hair Loss
C129245 FAC05013 FAC050-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18

Treatment Side Effect Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - Bothered by
C129246 FAC05014 FAC050-I Have Been National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Vomiting Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have Been
18 Version 2 - I have been vomiting. Vomiting
by Skin Problems Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am
18 Version 2 - I am bothered by skin problems. Bothered by Skin
Problems
C129248 FAC05016 FAC050-I Am Able to Get National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Around by Myself Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am Able to
18 Version 2 - I am able to get around by myself. Get Around by Myself
C129249 FAC05017 FAC050-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Enjoy Life Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am Able to
C129250 FAC05018 FAC050-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Quality of My Life Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - Content With
right now.
page 555 of 1925

Ovarian Symptom Index-18 Version 2 Questionnaire Test Name)
C129097 FAC050TN
Code Value
C129245 FAC050-Bothered by FAC050-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18

Treatment Side Effect Treatment Side Effect Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - Bothered by
C129250 FAC050-Content With FAC050-Content With National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Quality of My Life Quality of My Life Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - Content With
right now.
C129249 FAC050-I Am Able to FAC050-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Enjoy Life Enjoy Life Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am Able to
C129248 FAC050-I Am Able to Get FAC050-I Am Able to Get National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Around by Myself Around by Myself Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am Able to
18 Version 2 - I am able to get around by myself. Get Around by Myself
C129238 FAC050-I Am Bothered FAC050-I Am Bothered National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
by Constipation by Constipation Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am
18 Version 2 - I am bothered by constipation. Bothered by Constipation
by Hair Loss by Hair Loss Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am
18 Version 2 - I am bothered by hair loss. Bothered by Hair Loss
by Skin Problems by Skin Problems Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am
18 Version 2 - I am bothered by skin problems. Bothered by Skin
Problems
C129241 FAC050-I Am Sleeping FAC050-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Well Well Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Am Sleeping
C129237 FAC050-I Feel Fatigued FAC050-I Feel Fatigued National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Feel
C129235 FAC050-I Feel Ill FAC050-I Feel Ill National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Feel Ill
C129233 FAC050-I Have a Lack of FAC050-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Energy Energy Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have a Lack
C129246 FAC050-I Have Been FAC050-I Have Been National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Vomiting Vomiting Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have Been
18 Version 2 - I have been vomiting. Vomiting
C129240 FAC050-I Have Control of FAC050-I Have Control of National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
My Bowels My Bowels Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have Control
C129236 FAC050-I Have Cramps in FAC050-I Have Cramps in National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
My Stomach Area My Stomach Area Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have
18 Version 2 - I have cramps in my stomach area. Cramps in My Stomach
Area
C129243 FAC050-I Have Nausea FAC050-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have
C129234 FAC050-I Have Pain FAC050-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have Pain
C129239 FAC050-I Have Swelling FAC050-I Have Swelling National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18
in Stomach Area in Stomach Area Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - I Have
18 Version 2 - I have swelling in my stomach area. Swelling in Stomach Area
C129242 FAC050-Worry My FAC050-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT FOSI-18

Condition Will Get Worse Condition Will Get Worse Assessment of Cancer Therapy-Ovarian Symptom Index- Version 2 - Worry My
page 556 of 1925

FAC052TC (The National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-
Prostate Symptom Index 17 Version 2 Questionnaire Test Code)
C127356 FAC052TC
Code Value
C127448 FAC05201 FAC052-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Energy Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have a Lack
C127449 FAC05202 FAC052-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have Pain
C127450 FAC05203 FAC052-I Have Difficulty National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Urinating Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have
17 Version 2 - I have difficulty urinating. Difficulty Urinating
C127451 FAC05204 FAC052-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

Weight Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Am Losing
C127452 FAC05205 FAC052-I Have Bone Pain National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have Bone
C127453 FAC05206 FAC052-I Feel Fatigued National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Feel
C127454 FAC05207 FAC052-I Have Weakness National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
in My Legs Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have
17 Version 2 - I have weakness in my legs. Weakness in My Legs
C127455 FAC05208 FAC052-Pain Keeps Me National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

From Doing Things Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - Pain Keeps Me
17 Version 2 - My pain keeps me from doing things I From Doing Things
want to do.
C127456 FAC05209 FAC052-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Appetite Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have a Good
C127457 FAC05210 FAC052-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

Well Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Am Sleeping
C127458 FAC05211 FAC052-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

Condition Will Get Worse Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - Worry My
C127459 FAC05212 FAC052-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have
C127460 FAC05213 FAC052-I Have Trouble National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Moving My Bowels Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have
17 Version 2 - I have trouble moving my bowels. Trouble Moving My
Bowels
C127461 FAC05214 FAC052-I Am Satisfied National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

With My Sex Life Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Am Satisfied
17 Version 2 - I am satisfied with my sex life. With My Sex Life
C127462 FAC05215 FAC052-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

Treatment Side Effect Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - Bothered by
C127463 FAC05216 FAC052-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

Enjoy Life Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Am Able to
C127464 FAC05217 FAC052-Content With National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

Quality of My Life Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - Content With
right now.
page 557 of 1925

FAC052TN (The National Comprehensive Cancer Network/Functional Assessment of Cancer Therapy-
Prostate Symptom Index 17 Version 2 Questionnaire Test Name)
C127355 FAC052TN
Code Value
C127462 FAC052-Bothered by FAC052-Bothered by National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

Treatment Side Effect Treatment Side Effect Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - Bothered by
C127464 FAC052-Content With FAC052-Content With National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Quality of My Life Quality of My Life Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - Content With
right now.
C127463 FAC052-I Am Able to FAC052-I Am Able to National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Enjoy Life Enjoy Life Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Am Able to
C127451 FAC052-I Am Losing FAC052-I Am Losing National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Weight Weight Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Am Losing
C127461 FAC052-I Am Satisfied FAC052-I Am Satisfied National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
With My Sex Life With My Sex Life Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Am Satisfied
17 Version 2 - I am satisfied with my sex life. With My Sex Life
C127457 FAC052-I Am Sleeping FAC052-I Am Sleeping National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Well Well Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Am Sleeping
C127453 FAC052-I Feel Fatigued FAC052-I Feel Fatigued National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Feel
C127456 FAC052-I Have a Good FAC052-I Have a Good National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Appetite Appetite Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have a Good
C127448 FAC052-I Have a Lack of FAC052-I Have a Lack of National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Energy Energy Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have a Lack
C127452 FAC052-I Have Bone Pain FAC052-I Have Bone Pain National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have Bone
C127450 FAC052-I Have Difficulty FAC052-I Have Difficulty National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Urinating Urinating Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have
17 Version 2 - I have difficulty urinating. Difficulty Urinating
C127459 FAC052-I Have Nausea FAC052-I Have Nausea National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have
C127449 FAC052-I Have Pain FAC052-I Have Pain National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have Pain
C127460 FAC052-I Have Trouble FAC052-I Have Trouble National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
Moving My Bowels Moving My Bowels Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have
17 Version 2 - I have trouble moving my bowels. Trouble Moving My
Bowels
C127454 FAC052-I Have Weakness FAC052-I Have Weakness National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
in My Legs in My Legs Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - I Have
17 Version 2 - I have weakness in my legs. Weakness in My Legs
C127455 FAC052-Pain Keeps Me FAC052-Pain Keeps Me National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17
From Doing Things From Doing Things Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - Pain Keeps Me
17 Version 2 - My pain keeps me from doing things I From Doing Things
want to do.
C127458 FAC052-Worry My FAC052-Worry My National Comprehensive Cancer Network/Functional NCCN-FACT-FPSI 17

Condition Will Get Worse Condition Will Get Worse Assessment of Cancer Therapy-Prostate Symptom Index Version 2 - Worry My
page 558 of 1925

FAC057TC (Functional Assessment of Cancer Functional Assessment of Cancer Therapy/Gynecologic
Oncology Group-Neurotoxicity Version 4 Questionnaire Test Code)
C150780 FAC057TC
Code Value
C151196 FAC05701 FAC057-I Have a Lack of Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Energy Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Have a Lack of Energy
Being: I have a lack of energy.
C151197 FAC05702 FAC057-I Have Nausea Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Have Nausea
Being: I have nausea.
C151198 FAC05703 FAC057-Trouble Meeting Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Needs of Family Oncology Group-Neurotoxicity Version 4 - Physical Well- - Trouble Meeting Needs
Being: Because of my physical condition, I have trouble of Family
C151199 FAC05704 FAC057-I Have Pain Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Have Pain
Being: I have pain.
C151200 FAC05705 FAC057-Bothered by Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Treatment Side Effect Oncology Group-Neurotoxicity Version 4 - Physical Well- - Bothered by Treatment
Being: I am bothered by side effects of treatment. Side Effect
C151201 FAC05706 FAC057-I Feel Ill Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Feel Ill
Being: I feel ill.
C151202 FAC05707 FAC057-I Am Forced to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Spend Time in Bed Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Am Forced to Spend
Being: I am forced to spend time in bed. Time in Bed
C151203 FAC05708 FAC057-I Feel Close to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
My Friends Oncology Group-Neurotoxicity Version 4 - Social/Family - I Feel Close to My
Well-Being: I feel close to my friends. Friends
C151204 FAC05709 FAC057-Get Emotional Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Support From Family Oncology Group-Neurotoxicity Version 4 - Social/Family - Get Emotional Support
Well-Being: I get emotional support from my family. From Family
C151205 FAC05710 FAC057-I Get Support Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
From My Friends Oncology Group-Neurotoxicity Version 4 - Social/Family - I Get Support From My
Well-Being: I get support from my friends. Friends
C151206 FAC05711 FAC057-My Family Has Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Accepted My Illness Oncology Group-Neurotoxicity Version 4 - Social/Family - My Family Has Accepted
Well-Being: My family has accepted my illness. My Illness
C151207 FAC05712 FAC057-Satisfied Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Communication Illness Oncology Group-Neurotoxicity Version 4 - Social/Family - Satisfied
Well-Being: I am satisfied with family communication Communication Illness
about my illness.
C151208 FAC05713 FAC057-I Feel Close to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
My Partner Oncology Group-Neurotoxicity Version 4 - Social/Family - I Feel Close to My
Well-Being: I feel close to my partner (or the person who Partner
is my main support).
C151209 FAC05714 FAC057-I Am Satisfied Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
With My Sex Life Oncology Group-Neurotoxicity Version 4 - Social/Family - I Am Satisfied With My
Well-Being: I am satisfied with my sex life. Sex Life
C151210 FAC05715 FAC057-I Feel Sad Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Emotional Well- - I Feel Sad
Being: I feel sad.
C151211 FAC05716 FAC057-Satisfied With Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
How I Am Coping Oncology Group-Neurotoxicity Version 4 - Emotional Well- - Satisfied With How I Am
Being: I am satisfied with how I am coping with my Coping
illness.
C151212 FAC05717 FAC057-Losing Hope Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Against Illness Oncology Group-Neurotoxicity Version 4 - Emotional Well- - Losing Hope Against
Being: I am losing hope in the fight against my illness. Illness
C151213 FAC05718 FAC057-I Feel Nervous Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Emotional Well- - I Feel Nervous
Being: I feel nervous.
page 559 of 1925

C150780 FAC057TC
Code Value
C151214 FAC05719 FAC057-I Worry About Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Dying Oncology Group-Neurotoxicity Version 4 - Emotional Well- - I Worry About Dying
Being: I worry about dying.
C151215 FAC05720 FAC057-Worry My Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Condition Will Get Worse Oncology Group-Neurotoxicity Version 4 - Emotional Well- - Worry My Condition Will
Being: I worry that my condition will get worse. Get Worse
C151216 FAC05721 FAC057-I Am Able to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Work Oncology Group-Neurotoxicity Version 4 - Functional - I Am Able to Work
Well-Being: I am able to work (include work at home).
C151217 FAC05722 FAC057-My Work Is Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Fulfilling Oncology Group-Neurotoxicity Version 4 - Functional - My Work Is Fulfilling
Well-Being: My work (include work at home) is fulfilling.
C151218 FAC05723 FAC057-I Am Able to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Enjoy Life Oncology Group-Neurotoxicity Version 4 - Functional - I Am Able to Enjoy Life
Well-Being: I am able to enjoy life.
C151219 FAC05724 FAC057-I Have Accepted Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
My Illness Oncology Group-Neurotoxicity Version 4 - Functional - I Have Accepted My
Well-Being: I have accepted my illness. Illness
C151220 FAC05725 FAC057-I Am Sleeping Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Well Oncology Group-Neurotoxicity Version 4 - Functional - I Am Sleeping Well
Well-Being: I am sleeping well.
C151221 FAC05726 FAC057-Enjoy Things I Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Usually Do for Fun Oncology Group-Neurotoxicity Version 4 - Functional - Enjoy Things I Usually
Well-Being: I am enjoying the things I usually do for fun. Do for Fun
C151222 FAC05727 FAC057-Content With Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Quality of My Life Oncology Group-Neurotoxicity Version 4 - Functional - Content With Quality of
Well-Being: I am content with the quality of my life right My Life
now.
C151223 FAC05728 FAC057-Numbness or Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Tingling in My Hands Oncology Group-Neurotoxicity Version 4 - Additional - Numbness or Tingling in
Concerns: I have numbness or tingling in my hands. My Hands
C151224 FAC05729 FAC057-Numbness or Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Tingling in My Feet Oncology Group-Neurotoxicity Version 4 - Additional - Numbness or Tingling in
Concerns: I have numbness or tingling in my feet. My Feet
C151225 FAC05730 FAC057-I Feel Discomfort Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
in My Hands Oncology Group-Neurotoxicity Version 4 - Additional - I Feel Discomfort in My
Concerns: I feel discomfort in my hands. Hands
C151226 FAC05731 FAC057-I Feel Discomfort Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
in My Feet Oncology Group-Neurotoxicity Version 4 - Additional - I Feel Discomfort in My
Concerns: I feel discomfort in my feet. Feet
C151227 FAC05732 FAC057-Have Joint Pain Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
or Muscle Cramps Oncology Group-Neurotoxicity Version 4 - Additional - Have Joint Pain or
Concerns: I have joint pain or muscle cramps. Muscle Cramps
C151228 FAC05733 FAC057-I Feel Weak All Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Over Oncology Group-Neurotoxicity Version 4 - Additional - I Feel Weak All Over
Concerns: I feel weak all over.
C151229 FAC05734 FAC057-I Have Trouble Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Hearing Oncology Group-Neurotoxicity Version 4 - Additional - I Have Trouble Hearing
Concerns: I have trouble hearing.
C151230 FAC05735 FAC057-Get Ringing or Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Buzzing in My Ears Oncology Group-Neurotoxicity Version 4 - Additional - Get Ringing or Buzzing
Concerns: I get a ringing or buzzing in my ears. in My Ears
Buttoning Buttons Oncology Group-Neurotoxicity Version 4 - Additional - I Have Trouble
Concerns: I have trouble buttoning buttons. Buttoning Buttons
C151232 FAC05737 FAC057-Trouble Feeling Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Shape of Objects Oncology Group-Neurotoxicity Version 4 - Additional - Trouble Feeling Shape
Concerns: I have trouble feeling the shape of small of Objects
objects when they are in my hand.
Walking Oncology Group-Neurotoxicity Version 4 - Additional - I Have Trouble Walking
Concerns: I have trouble walking.
page 560 of 1925

FAC057TN (Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity
Version 4 Questionnaire Test Name)
C150779 FAC057TN
Code Value
C151200 FAC057-Bothered by FAC057-Bothered by Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Treatment Side Effect Treatment Side Effect Oncology Group-Neurotoxicity Version 4 - Physical Well- - Bothered by Treatment
Being: I am bothered by side effects of treatment. Side Effect
C151222 FAC057-Content With FAC057-Content With Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Quality of My Life Quality of My Life Oncology Group-Neurotoxicity Version 4 - Functional - Content With Quality of
Well-Being: I am content with the quality of my life right My Life
now.
C151221 FAC057-Enjoy Things I FAC057-Enjoy Things I Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Usually Do for Fun Usually Do for Fun Oncology Group-Neurotoxicity Version 4 - Functional - Enjoy Things I Usually
Well-Being: I am enjoying the things I usually do for fun. Do for Fun
C151204 FAC057-Get Emotional FAC057-Get Emotional Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Support From Family Support From Family Oncology Group-Neurotoxicity Version 4 - Social/Family - Get Emotional Support
Well-Being: I get emotional support from my family. From Family
C151230 FAC057-Get Ringing or FAC057-Get Ringing or Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Buzzing in My Ears Buzzing in My Ears Oncology Group-Neurotoxicity Version 4 - Additional - Get Ringing or Buzzing
Concerns: I get a ringing or buzzing in my ears. in My Ears
C151227 FAC057-Have Joint Pain FAC057-Have Joint Pain Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
or Muscle Cramps or Muscle Cramps Oncology Group-Neurotoxicity Version 4 - Additional - Have Joint Pain or
Concerns: I have joint pain or muscle cramps. Muscle Cramps
C151218 FAC057-I Am Able to FAC057-I Am Able to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Enjoy Life Enjoy Life Oncology Group-Neurotoxicity Version 4 - Functional - I Am Able to Enjoy Life
Well-Being: I am able to enjoy life.
C151216 FAC057-I Am Able to FAC057-I Am Able to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Work Work Oncology Group-Neurotoxicity Version 4 - Functional - I Am Able to Work
Well-Being: I am able to work (include work at home).
C151202 FAC057-I Am Forced to FAC057-I Am Forced to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Spend Time in Bed Spend Time in Bed Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Am Forced to Spend
Being: I am forced to spend time in bed. Time in Bed
C151209 FAC057-I Am Satisfied FAC057-I Am Satisfied Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
With My Sex Life With My Sex Life Oncology Group-Neurotoxicity Version 4 - Social/Family - I Am Satisfied With My
Well-Being: I am satisfied with my sex life. Sex Life
C151220 FAC057-I Am Sleeping FAC057-I Am Sleeping Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Well Well Oncology Group-Neurotoxicity Version 4 - Functional - I Am Sleeping Well
Well-Being: I am sleeping well.
C151203 FAC057-I Feel Close to FAC057-I Feel Close to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
My Friends My Friends Oncology Group-Neurotoxicity Version 4 - Social/Family - I Feel Close to My
Well-Being: I feel close to my friends. Friends
C151208 FAC057-I Feel Close to FAC057-I Feel Close to Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
My Partner My Partner Oncology Group-Neurotoxicity Version 4 - Social/Family - I Feel Close to My
Well-Being: I feel close to my partner (or the person who Partner
is my main support).
C151226 FAC057-I Feel Discomfort FAC057-I Feel Discomfort Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
in My Feet in My Feet Oncology Group-Neurotoxicity Version 4 - Additional - I Feel Discomfort in My
Concerns: I feel discomfort in my feet. Feet
C151225 FAC057-I Feel Discomfort FAC057-I Feel Discomfort Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
in My Hands in My Hands Oncology Group-Neurotoxicity Version 4 - Additional - I Feel Discomfort in My
Concerns: I feel discomfort in my hands. Hands
C151201 FAC057-I Feel Ill FAC057-I Feel Ill Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Feel Ill
Being: I feel ill.
C151213 FAC057-I Feel Nervous FAC057-I Feel Nervous Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Emotional Well- - I Feel Nervous
Being: I feel nervous.
C151210 FAC057-I Feel Sad FAC057-I Feel Sad Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Emotional Well- - I Feel Sad
Being: I feel sad.
C151228 FAC057-I Feel Weak All FAC057-I Feel Weak All Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Over Over Oncology Group-Neurotoxicity Version 4 - Additional - I Feel Weak All Over
Concerns: I feel weak all over.
page 561 of 1925

C150779 FAC057TN
Code Value
C151205 FAC057-I Get Support FAC057-I Get Support Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
From My Friends From My Friends Oncology Group-Neurotoxicity Version 4 - Social/Family - I Get Support From My
Well-Being: I get support from my friends. Friends
C151196 FAC057-I Have a Lack of FAC057-I Have a Lack of Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Energy Energy Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Have a Lack of Energy
Being: I have a lack of energy.
C151219 FAC057-I Have Accepted FAC057-I Have Accepted Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
My Illness My Illness Oncology Group-Neurotoxicity Version 4 - Functional - I Have Accepted My
Well-Being: I have accepted my illness. Illness
C151197 FAC057-I Have Nausea FAC057-I Have Nausea Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Have Nausea
Being: I have nausea.
C151199 FAC057-I Have Pain FAC057-I Have Pain Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Oncology Group-Neurotoxicity Version 4 - Physical Well- - I Have Pain
Being: I have pain.
C151231 FAC057-I Have Trouble FAC057-I Have Trouble Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Buttoning Buttons Buttoning Buttons Oncology Group-Neurotoxicity Version 4 - Additional - I Have Trouble
Concerns: I have trouble buttoning buttons. Buttoning Buttons
Hearing Hearing Oncology Group-Neurotoxicity Version 4 - Additional - I Have Trouble Hearing
Concerns: I have trouble hearing.
Walking Walking Oncology Group-Neurotoxicity Version 4 - Additional - I Have Trouble Walking
Concerns: I have trouble walking.
C151214 FAC057-I Worry About FAC057-I Worry About Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Dying Dying Oncology Group-Neurotoxicity Version 4 - Emotional Well- - I Worry About Dying
Being: I worry about dying.
C151212 FAC057-Losing Hope FAC057-Losing Hope Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Against Illness Against Illness Oncology Group-Neurotoxicity Version 4 - Emotional Well- - Losing Hope Against
Being: I am losing hope in the fight against my illness. Illness
C151206 FAC057-My Family Has FAC057-My Family Has Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Accepted My Illness Accepted My Illness Oncology Group-Neurotoxicity Version 4 - Social/Family - My Family Has Accepted
Well-Being: My family has accepted my illness. My Illness
C151217 FAC057-My Work Is FAC057-My Work Is Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Fulfilling Fulfilling Oncology Group-Neurotoxicity Version 4 - Functional - My Work Is Fulfilling
Well-Being: My work (include work at home) is fulfilling.
C151224 FAC057-Numbness or FAC057-Numbness or Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Tingling in My Feet Tingling in My Feet Oncology Group-Neurotoxicity Version 4 - Additional - Numbness or Tingling in
Concerns: I have numbness or tingling in my feet. My Feet
C151223 FAC057-Numbness or FAC057-Numbness or Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Tingling in My Hands Tingling in My Hands Oncology Group-Neurotoxicity Version 4 - Additional - Numbness or Tingling in
Concerns: I have numbness or tingling in my hands. My Hands
C151207 FAC057-Satisfied FAC057-Satisfied Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Communication Illness Communication Illness Oncology Group-Neurotoxicity Version 4 - Social/Family - Satisfied
Well-Being: I am satisfied with family communication Communication Illness
about my illness.
C151211 FAC057-Satisfied With FAC057-Satisfied With Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
How I Am Coping How I Am Coping Oncology Group-Neurotoxicity Version 4 - Emotional Well- - Satisfied With How I Am
Being: I am satisfied with how I am coping with my Coping
illness.
C151232 FAC057-Trouble Feeling FAC057-Trouble Feeling Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Shape of Objects Shape of Objects Oncology Group-Neurotoxicity Version 4 - Additional - Trouble Feeling Shape
Concerns: I have trouble feeling the shape of small of Objects
objects when they are in my hand.
C151198 FAC057-Trouble Meeting FAC057-Trouble Meeting Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4
Needs of Family Needs of Family Oncology Group-Neurotoxicity Version 4 - Physical Well- - Trouble Meeting Needs
Being: Because of my physical condition, I have trouble of Family
C151215 FAC057-Worry My FAC057-Worry My Functional Assessment of Cancer Therapy/Gynecologic FACT/GOG-NTX Version 4

Condition Will Get Worse Condition Will Get Worse Oncology Group-Neurotoxicity Version 4 - Emotional Well- - Worry My Condition Will
Being: I worry that my condition will get worse. Get Worse
page 562 of 1925

FAC061TC (Functional Assessment of Cancer Therapy-Bone Marrow Transplant Version 4
C147540 FAC061TC
Code Value
C147593 FAC06101 FAC061-I Have a Lack of Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Energy Transplant Version 4 - I have a lack of energy. Have a Lack of Energy
C147594 FAC06102 FAC061-I Have Nausea Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I have nausea. Have Nausea
C147595 FAC06103 FAC061-Trouble Meeting Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Needs of Family Transplant Version 4 - Because of my physical condition, I Trouble Meeting Needs of
C147596 FAC06104 FAC061-I Have Pain Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I have pain. Have Pain
C147597 FAC06105 FAC061-Bothered by Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Treatment Side Effect Transplant Version 4 - I am bothered by side effects of Bothered by Treatment
C147598 FAC06106 FAC061-I Feel Ill Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I feel ill. Feel Ill
C147599 FAC06107 FAC061-I Am Forced to Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Spend Time in Bed Transplant Version 4 - I am forced to spend time in bed. Am Forced to Spend Time
in Bed
C147600 FAC06108 FAC061-I Feel Close to Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
My Friends Transplant Version 4 - I feel close to my friends. Feel Close to My Friends
C147601 FAC06109 FAC061-Get Emotional Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - Get
Support From Family Transplant Version 4 - I get emotional support from my Emotional Support From
family. Family
C147602 FAC06110 FAC061-I Get Support Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
From My Friends Transplant Version 4 - I get support from my friends. Get Support From My
Friends
C147603 FAC06111 FAC061-My Family Has Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - My
Accepted My Illness Transplant Version 4 - My family has accepted my illness. Family Has Accepted My
Illness
C147604 FAC06112 FAC061-Satisfied Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Communication Illness Transplant Version 4 - I am satisfied with family Satisfied Communication
C147605 FAC06113 FAC061-I Feel Close to Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
My Partner Transplant Version 4 - I feel close to my partner (or the Feel Close to My Partner
person who is my main support).
C147606 FAC06114 FAC061-I Am Satisfied Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
With My Sex Life Transplant Version 4 - I am satisfied with my sex life. Am Satisfied With My Sex
Life
C147607 FAC06115 FAC061-I Feel Sad Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I feel sad. Feel Sad
C147608 FAC06116 FAC061-Satisfied With Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
How I Am Coping Transplant Version 4 - I am satisfied with how I am Satisfied With How I Am
C147609 FAC06117 FAC061-Losing Hope Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Against Illness Transplant Version 4 - I am losing hope in the fight Losing Hope Against
against my illness. Illness
C147610 FAC06118 FAC061-I Feel Nervous Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I feel nervous. Feel Nervous
C147611 FAC06119 FAC061-I Worry About Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Dying Transplant Version 4 - I worry about dying. Worry About Dying
C147612 FAC06120 FAC061-Worry My Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Condition Will Get Worse Transplant Version 4 - I worry that my condition will get Worry My Condition Will
worse. Get Worse
C147613 FAC06121 FAC061-I Am Able to Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Work Transplant Version 4 - I am able to work (include work at Am Able to Work
home).
page 563 of 1925

C147540 FAC061TC
Code Value
C147614 FAC06122 FAC061-My Work Is Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - My
Fulfilling Transplant Version 4 - My work (include work at home) is Work Is Fulfilling
fulfilling.
Enjoy Life Transplant Version 4 - I am able to enjoy life. Am Able to Enjoy Life
C147616 FAC06124 FAC061-I Have Accepted Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
My Illness Transplant Version 4 - I have accepted my illness. Have Accepted My Illness
C147617 FAC06125 FAC061-I Am Sleeping Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Well Transplant Version 4 - I am sleeping well. Am Sleeping Well
C147618 FAC06126 FAC061-Enjoy Things I Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Usually Do for Fun Transplant Version 4 - I am enjoying the things I usually Enjoy Things I Usually Do
do for fun. for Fun
C147619 FAC06127 FAC061-Content With Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Quality of My Life Transplant Version 4 - I am content with the quality of Content With Quality of
C147620 FAC06128 FAC061-I Am Concerned Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
About Keeping Job Transplant Version 4 - I am concerned about keeping my Am Concerned About
job (include work at home). Keeping Job
C147621 FAC06129 FAC061-I Feel Distant Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
From Other People Transplant Version 4 - I feel distant from other people. Feel Distant From Other
People
C147622 FAC06130 FAC061-I Worry Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Will Not Work Transplant Version 4 - I worry that the transplant will not Worry Transplant Will Not
work. Work
C147623 FAC06131 FAC061-Side Effect of Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Treatment Worse Transplant Version 4 - The side effects of treatment are Side Effect of Treatment
worse than I had imagined. Worse
C147624 FAC06132 FAC061-I Have a Good Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Appetite Transplant Version 4 - I have a good appetite. Have a Good Appetite
C147625 FAC06133 FAC061-I Like the Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Appearance of My Body Transplant Version 4 - I like the appearance of my body. Like the Appearance of
My Body
C147626 FAC06134 FAC061-I Am Able to Get Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Around by Myself Transplant Version 4 - I am able to get around by myself. Am Able to Get Around by
Myself
C147627 FAC06135 FAC061-I Get Tired Easily Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I get tired easily. Get Tired Easily
C147628 FAC06136 FAC061-I Am Interested Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
in Sex Transplant Version 4 - I am interested in sex. Am Interested in Sex
C147629 FAC06137 FAC061-Concerns Ability Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
to Have Children Transplant Version 4 - I have concerns about my ability Concerns Ability to Have
to have children. Children
C147630 FAC06138 FAC061-Confidence in My Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Nurse(s) Transplant Version 4 - I have confidence in my nurse(s). Confidence in My
Nurse(s)
C147631 FAC06139 FAC061-I Regret Bone Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Marrow Transplant Transplant Version 4 - I regret having the bone marrow Regret Bone Marrow
transplant. Transplant
C147632 FAC06140 FAC061-I Can Remember Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Things Transplant Version 4 - I can remember things. Can Remember Things
Concentrate Transplant Version 4 - I am able to concentrate. Am Able to Concentrate
C147634 FAC06142 FAC061-I Have Frequent Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Colds/Infections Transplant Version 4 - I have frequent colds/infections. Have Frequent
Colds/Infections
C147635 FAC06143 FAC061-My Eyesight Is Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - My
Blurry Transplant Version 4 - My eyesight is blurry. Eyesight Is Blurry
C147636 FAC06144 FAC061-Bothered by Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Change in Food Tastes Transplant Version 4 - I am bothered by a change in the Bothered by Change in
way food tastes. Food Tastes
page 564 of 1925

C147540 FAC061TC
Code Value
C147637 FAC06145 FAC061-I Have Tremors Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I have tremors. Have Tremors
C147638 FAC06146 FAC061-I Have Been Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Short of Breath Transplant Version 4 - I have been short of breath. Have Been Short of
Breath
C147639 FAC06147 FAC061-I Am Bothered Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
by Skin Problems Transplant Version 4 - I am bothered by skin problems. Am Bothered by Skin
Problems
C147640 FAC06148 FAC061-I Have Trouble Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
With My Bowels Transplant Version 4 - I have trouble with my bowels. Have Trouble With My
Bowels
C147641 FAC06149 FAC061-Illness Is Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Hardship for My Family Transplant Version 4 - My illness is a personal hardship Illness Is Hardship for My
for my close family members. Family
C147642 FAC06150 FAC061-Cost of Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Treatment Is Burden on Transplant Version 4 - The cost of my treatment is a Cost of Treatment Is
Me burden on me or my family. Burden on Me
page 565 of 1925

FAC061TN (Functional Assessment of Cancer Therapy-Bone Marrow Transplant Version 4
C147539 FAC061TN
Code Value
C147636 FAC061-Bothered by FAC061-Bothered by Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Change in Food Tastes Change in Food Tastes Transplant Version 4 - I am bothered by a change in the Bothered by Change in
way food tastes. Food Tastes
C147597 FAC061-Bothered by FAC061-Bothered by Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Treatment Side Effect Treatment Side Effect Transplant Version 4 - I am bothered by side effects of Bothered by Treatment
C147629 FAC061-Concerns Ability FAC061-Concerns Ability Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
to Have Children to Have Children Transplant Version 4 - I have concerns about my ability Concerns Ability to Have
to have children. Children
C147630 FAC061-Confidence in My FAC061-Confidence in My Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Nurse(s) Nurse(s) Transplant Version 4 - I have confidence in my nurse(s). Confidence in My
Nurse(s)
C147619 FAC061-Content With FAC061-Content With Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Quality of My Life Quality of My Life Transplant Version 4 - I am content with the quality of Content With Quality of
C147642 FAC061-Cost of FAC061-Cost of Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Treatment Is Burden on Treatment Is Burden on Transplant Version 4 - The cost of my treatment is a Cost of Treatment Is
Me Me burden on me or my family. Burden on Me
C147618 FAC061-Enjoy Things I FAC061-Enjoy Things I Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Usually Do for Fun Usually Do for Fun Transplant Version 4 - I am enjoying the things I usually Enjoy Things I Usually Do
do for fun. for Fun
C147601 FAC061-Get Emotional FAC061-Get Emotional Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - Get
Support From Family Support From Family Transplant Version 4 - I get emotional support from my Emotional Support From
family. Family
C147633 FAC061-I Am Able to FAC061-I Am Able to Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Concentrate Concentrate Transplant Version 4 - I am able to concentrate. Am Able to Concentrate
Enjoy Life Enjoy Life Transplant Version 4 - I am able to enjoy life. Am Able to Enjoy Life
C147626 FAC061-I Am Able to Get FAC061-I Am Able to Get Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Around by Myself Around by Myself Transplant Version 4 - I am able to get around by myself. Am Able to Get Around by
Myself
Work Work Transplant Version 4 - I am able to work (include work at Am Able to Work
home).
C147639 FAC061-I Am Bothered FAC061-I Am Bothered Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
by Skin Problems by Skin Problems Transplant Version 4 - I am bothered by skin problems. Am Bothered by Skin
Problems
C147620 FAC061-I Am Concerned FAC061-I Am Concerned Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
About Keeping Job About Keeping Job Transplant Version 4 - I am concerned about keeping my Am Concerned About
job (include work at home). Keeping Job
C147599 FAC061-I Am Forced to FAC061-I Am Forced to Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Spend Time in Bed Spend Time in Bed Transplant Version 4 - I am forced to spend time in bed. Am Forced to Spend Time
in Bed
C147628 FAC061-I Am Interested FAC061-I Am Interested Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
in Sex in Sex Transplant Version 4 - I am interested in sex. Am Interested in Sex
C147606 FAC061-I Am Satisfied FAC061-I Am Satisfied Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
With My Sex Life With My Sex Life Transplant Version 4 - I am satisfied with my sex life. Am Satisfied With My Sex
Life
C147617 FAC061-I Am Sleeping FAC061-I Am Sleeping Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Well Well Transplant Version 4 - I am sleeping well. Am Sleeping Well
C147632 FAC061-I Can Remember FAC061-I Can Remember Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Things Things Transplant Version 4 - I can remember things. Can Remember Things
C147600 FAC061-I Feel Close to FAC061-I Feel Close to Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
My Friends My Friends Transplant Version 4 - I feel close to my friends. Feel Close to My Friends
C147605 FAC061-I Feel Close to FAC061-I Feel Close to Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
My Partner My Partner Transplant Version 4 - I feel close to my partner (or the Feel Close to My Partner
person who is my main support).
page 566 of 1925

C147539 FAC061TN
Code Value
C147621 FAC061-I Feel Distant FAC061-I Feel Distant Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
From Other People From Other People Transplant Version 4 - I feel distant from other people. Feel Distant From Other
People
C147598 FAC061-I Feel Ill FAC061-I Feel Ill Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I feel ill. Feel Ill
C147610 FAC061-I Feel Nervous FAC061-I Feel Nervous Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I feel nervous. Feel Nervous
C147607 FAC061-I Feel Sad FAC061-I Feel Sad Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I feel sad. Feel Sad
C147602 FAC061-I Get Support FAC061-I Get Support Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
From My Friends From My Friends Transplant Version 4 - I get support from my friends. Get Support From My
Friends
C147627 FAC061-I Get Tired Easily FAC061-I Get Tired Easily Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I get tired easily. Get Tired Easily
C147624 FAC061-I Have a Good FAC061-I Have a Good Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Appetite Appetite Transplant Version 4 - I have a good appetite. Have a Good Appetite
C147593 FAC061-I Have a Lack of FAC061-I Have a Lack of Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Energy Energy Transplant Version 4 - I have a lack of energy. Have a Lack of Energy
C147616 FAC061-I Have Accepted FAC061-I Have Accepted Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
My Illness My Illness Transplant Version 4 - I have accepted my illness. Have Accepted My Illness
C147638 FAC061-I Have Been FAC061-I Have Been Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Short of Breath Short of Breath Transplant Version 4 - I have been short of breath. Have Been Short of
Breath
C147634 FAC061-I Have Frequent FAC061-I Have Frequent Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Colds/Infections Colds/Infections Transplant Version 4 - I have frequent colds/infections. Have Frequent
Colds/Infections
C147594 FAC061-I Have Nausea FAC061-I Have Nausea Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I have nausea. Have Nausea
C147596 FAC061-I Have Pain FAC061-I Have Pain Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I have pain. Have Pain
C147637 FAC061-I Have Tremors FAC061-I Have Tremors Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Version 4 - I have tremors. Have Tremors
C147640 FAC061-I Have Trouble FAC061-I Have Trouble Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
With My Bowels With My Bowels Transplant Version 4 - I have trouble with my bowels. Have Trouble With My
Bowels
C147625 FAC061-I Like the FAC061-I Like the Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Appearance of My Body Appearance of My Body Transplant Version 4 - I like the appearance of my body. Like the Appearance of
My Body
C147631 FAC061-I Regret Bone FAC061-I Regret Bone Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Marrow Transplant Marrow Transplant Transplant Version 4 - I regret having the bone marrow Regret Bone Marrow
transplant. Transplant
C147611 FAC061-I Worry About FAC061-I Worry About Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Dying Dying Transplant Version 4 - I worry about dying. Worry About Dying
C147622 FAC061-I Worry FAC061-I Worry Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - I
Transplant Will Not Work Transplant Will Not Work Transplant Version 4 - I worry that the transplant will not Worry Transplant Will Not
work. Work
C147641 FAC061-Illness Is FAC061-Illness Is Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Hardship for My Family Hardship for My Family Transplant Version 4 - My illness is a personal hardship Illness Is Hardship for My
for my close family members. Family
C147609 FAC061-Losing Hope FAC061-Losing Hope Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Against Illness Against Illness Transplant Version 4 - I am losing hope in the fight Losing Hope Against
C147635 FAC061-My Eyesight Is FAC061-My Eyesight Is Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - My
Blurry Blurry Transplant Version 4 - My eyesight is blurry. Eyesight Is Blurry
C147603 FAC061-My Family Has FAC061-My Family Has Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - My
Accepted My Illness Accepted My Illness Transplant Version 4 - My family has accepted my illness. Family Has Accepted My
Illness
C147614 FAC061-My Work Is FAC061-My Work Is Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 - My
Fulfilling Fulfilling Transplant Version 4 - My work (include work at home) is Work Is Fulfilling
fulfilling.
page 567 of 1925

C147539 FAC061TN
Code Value
C147604 FAC061-Satisfied FAC061-Satisfied Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Communication Illness Communication Illness Transplant Version 4 - I am satisfied with family Satisfied Communication
C147608 FAC061-Satisfied With FAC061-Satisfied With Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
How I Am Coping How I Am Coping Transplant Version 4 - I am satisfied with how I am Satisfied With How I Am
C147623 FAC061-Side Effect of FAC061-Side Effect of Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Treatment Worse Treatment Worse Transplant Version 4 - The side effects of treatment are Side Effect of Treatment
worse than I had imagined. Worse
C147595 FAC061-Trouble Meeting FAC061-Trouble Meeting Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Needs of Family Needs of Family Transplant Version 4 - Because of my physical condition, I Trouble Meeting Needs of
C147612 FAC061-Worry My FAC061-Worry My Functional Assessment of Cancer Therapy-Bone Marrow FACT-BMT Version 4 -
Condition Will Get Worse Condition Will Get Worse Transplant Version 4 - I worry that my condition will get Worry My Condition Will
worse. Get Worse
page 568 of 1925

FAC062TC (Functional Assessment of Cancer Therapy-Biologic Response Modifiers Version 4
C150778 FAC062TC
Code Value
C151156 FAC06201 FAC062-I Have a Lack of Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Energy Response Modifiers Version 4 - Physical Well-Being: I Have a Lack of Energy
C151157 FAC06202 FAC062-I Have Nausea Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Physical Well-Being: I Have Nausea
have nausea.
C151158 FAC06203 FAC062-Trouble Meeting Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Needs of Family Response Modifiers Version 4 - Physical Well-Being: Trouble Meeting Needs of
Because of my physical condition, I have trouble meeting Family
the needs of my family.
C151159 FAC06204 FAC062-I Have Pain Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Physical Well-Being: I Have Pain
have pain.
C151160 FAC06205 FAC062-Bothered by Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -

Treatment Side Effect Response Modifiers Version 4 - Physical Well-Being: I am Bothered by Treatment
bothered by side effects of treatment. Side Effect
C151161 FAC06206 FAC062-I Feel Ill Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Physical Well-Being: I feel Feel Ill
ill.
C151162 FAC06207 FAC062-I Am Forced to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Spend Time in Bed Response Modifiers Version 4 - Physical Well-Being: I am Am Forced to Spend Time
forced to spend time in bed. in Bed
C151163 FAC06208 FAC062-I Feel Close to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
My Friends Response Modifiers Version 4 - Social/Family Well-Being: Feel Close to My Friends
I feel close to my friends.
C151164 FAC06209 FAC062-Get Emotional Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Support From Family Response Modifiers Version 4 - Social/Family Well-Being: Get Emotional Support
I get emotional support from my family. From Family
C151165 FAC06210 FAC062-I Get Support Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
From My Friends Response Modifiers Version 4 - Social/Family Well-Being: Get Support From My
I get support from my friends. Friends
C151166 FAC06211 FAC062-My Family Has Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - My
Accepted My Illness Response Modifiers Version 4 - Social/Family Well-Being: Family Has Accepted My
My family has accepted my illness. Illness
C151167 FAC06212 FAC062-Satisfied Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -

Communication Illness Response Modifiers Version 4 - Social/Family Well-Being: Satisfied Communication
I am satisfied with family communication about my Illness
illness.
C151168 FAC06213 FAC062-I Feel Close to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
My Partner Response Modifiers Version 4 - Social/Family Well-Being: Feel Close to My Partner
I feel close to my partner (or the person who is my main
support).
C151169 FAC06214 FAC062-I Am Satisfied Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
With My Sex Life Response Modifiers Version 4 - Social/Family Well-Being: Am Satisfied With My Sex
I am satisfied with my sex life. Life
C151170 FAC06215 FAC062-I Feel Sad Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Emotional Well-Being: I Feel Sad
feel sad.
C151171 FAC06216 FAC062-Satisfied With Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
How I Am Coping Response Modifiers Version 4 - Emotional Well-Being: I Satisfied With How I Am
am satisfied with how I am coping with my illness. Coping
C151172 FAC06217 FAC062-Losing Hope Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Against Illness Response Modifiers Version 4 - Emotional Well-Being: I Losing Hope Against
am losing hope in the fight against my illness. Illness
C151173 FAC06218 FAC062-I Feel Nervous Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Emotional Well-Being: I Feel Nervous
feel nervous.
C151174 FAC06219 FAC062-I Worry About Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Dying Response Modifiers Version 4 - Emotional Well-Being: I Worry About Dying
worry about dying.
page 569 of 1925

C150778 FAC062TC
Code Value
C151175 FAC06220 FAC062-Worry My Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -

Condition Will Get Worse Response Modifiers Version 4 - Emotional Well-Being: I Worry My Condition Will
worry that my condition will get worse. Get Worse
C151176 FAC06221 FAC062-I Am Able to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Work Response Modifiers Version 4 - Functional Well-Being: I Am Able to Work
am able to work (include work at home).
C151177 FAC06222 FAC062-My Work Is Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - My
Fulfilling Response Modifiers Version 4 - Functional Well-Being: My Work Is Fulfilling
work (include work at home) is fulfilling.
C151178 FAC06223 FAC062-I Am Able to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Enjoy Life Response Modifiers Version 4 - Functional Well-Being: I Am Able to Enjoy Life
am able to enjoy life.
C151179 FAC06224 FAC062-I Have Accepted Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
My Illness Response Modifiers Version 4 - Functional Well-Being: I Have Accepted My Illness
have accepted my illness.
C151180 FAC06225 FAC062-I Am Sleeping Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Well Response Modifiers Version 4 - Functional Well-Being: I Am Sleeping Well
am sleeping well.
C151181 FAC06226 FAC062-Enjoy Things I Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Usually Do for Fun Response Modifiers Version 4 - Functional Well-Being: I Enjoy Things I Usually Do
am enjoying the things I usually do for fun. for Fun
C151182 FAC06227 FAC062-Content With Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Quality of My Life Response Modifiers Version 4 - Functional Well-Being: I Content With Quality of
am content with the quality of my life right now. My Life
C151183 FAC06228 FAC062-I Get Tired Easily Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Additional Concerns- Get Tired Easily
Physical: I get tired easily.
C151184 FAC06229 FAC062-I Feel Weak All Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Over Response Modifiers Version 4 - Additional Concerns- Feel Weak All Over
Physical: I feel weak all over.
C151185 FAC06230 FAC062-I Have a Good Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Appetite Response Modifiers Version 4 - Additional Concerns- Have a Good Appetite
Physical: I have a good appetite.
C151186 FAC06231 FAC062-I Have Pain in My Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Joints Response Modifiers Version 4 - Additional Concerns- Have Pain in My Joints
Physical: I have pain in my joints.
C151187 FAC06232 FAC062-I Am Bothered Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
by the Chills Response Modifiers Version 4 - Additional Concerns- Am Bothered by the Chills
Physical: I am bothered by the chills.
by Fevers Response Modifiers Version 4 - Additional Concerns- Am Bothered by Fevers
Physical: I am bothered by fevers (episodes of high body
temperature).
by Sweating Response Modifiers Version 4 - Additional Concerns- Am Bothered by Sweating
Physical: I am bothered by sweating.
C151190 FAC06235 FAC062-I Have Trouble Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Concentrating Response Modifiers Version 4 - Additional Concerns- Have Trouble
Mental: I have trouble concentrating. Concentrating
C151191 FAC06236 FAC062-I Have Trouble Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Remembering Things Response Modifiers Version 4 - Additional Concerns- Have Trouble
Mental: I have trouble remembering things. Remembering Things
C151192 FAC06237 FAC062-I Get Depressed Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Easily Response Modifiers Version 4 - Additional Concerns- Get Depressed Easily
Mental: I get depressed easily.
C151193 FAC06238 FAC062-I Get Annoyed Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Easily Response Modifiers Version 4 - Additional Concerns- Get Annoyed Easily
Mental: I get annoyed easily.
C151194 FAC06239 FAC062-I Have Emotional Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Ups and Downs Response Modifiers Version 4 - Additional Concerns- Have Emotional Ups and
Mental: I have emotional ups and downs. Downs
C151195 FAC06240 FAC062-I Feel Motivated Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
to Do Things Response Modifiers Version 4 - Additional Concerns- Feel Motivated to Do
Mental: I feel motivated to do things. Things
page 570 of 1925

FAC062TN (Functional Assessment of Cancer Therapy-Biologic Response Modifiers Version 4
C150777 FAC062TN
Code Value
C151160 FAC062-Bothered by FAC062-Bothered by Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -

Treatment Side Effect Treatment Side Effect Response Modifiers Version 4 - Physical Well-Being: I am Bothered by Treatment
bothered by side effects of treatment. Side Effect
C151182 FAC062-Content With FAC062-Content With Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Quality of My Life Quality of My Life Response Modifiers Version 4 - Functional Well-Being: I Content With Quality of
am content with the quality of my life right now. My Life
C151181 FAC062-Enjoy Things I FAC062-Enjoy Things I Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Usually Do for Fun Usually Do for Fun Response Modifiers Version 4 - Functional Well-Being: I Enjoy Things I Usually Do
am enjoying the things I usually do for fun. for Fun
C151164 FAC062-Get Emotional FAC062-Get Emotional Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Support From Family Support From Family Response Modifiers Version 4 - Social/Family Well-Being: Get Emotional Support
I get emotional support from my family. From Family
C151178 FAC062-I Am Able to FAC062-I Am Able to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Enjoy Life Enjoy Life Response Modifiers Version 4 - Functional Well-Being: I Am Able to Enjoy Life
am able to enjoy life.
C151176 FAC062-I Am Able to FAC062-I Am Able to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Work Work Response Modifiers Version 4 - Functional Well-Being: I Am Able to Work
am able to work (include work at home).
C151188 FAC062-I Am Bothered FAC062-I Am Bothered Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
by Fevers by Fevers Response Modifiers Version 4 - Additional Concerns- Am Bothered by Fevers
Physical: I am bothered by fevers (episodes of high body
temperature).
by Sweating by Sweating Response Modifiers Version 4 - Additional Concerns- Am Bothered by Sweating
Physical: I am bothered by sweating.
by the Chills by the Chills Response Modifiers Version 4 - Additional Concerns- Am Bothered by the Chills
Physical: I am bothered by the chills.
C151162 FAC062-I Am Forced to FAC062-I Am Forced to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Spend Time in Bed Spend Time in Bed Response Modifiers Version 4 - Physical Well-Being: I am Am Forced to Spend Time
forced to spend time in bed. in Bed
C151169 FAC062-I Am Satisfied FAC062-I Am Satisfied Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
With My Sex Life With My Sex Life Response Modifiers Version 4 - Social/Family Well-Being: Am Satisfied With My Sex
I am satisfied with my sex life. Life
C151180 FAC062-I Am Sleeping FAC062-I Am Sleeping Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Well Well Response Modifiers Version 4 - Functional Well-Being: I Am Sleeping Well
am sleeping well.
C151163 FAC062-I Feel Close to FAC062-I Feel Close to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
My Friends My Friends Response Modifiers Version 4 - Social/Family Well-Being: Feel Close to My Friends
I feel close to my friends.
C151168 FAC062-I Feel Close to FAC062-I Feel Close to Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
My Partner My Partner Response Modifiers Version 4 - Social/Family Well-Being: Feel Close to My Partner
I feel close to my partner (or the person who is my main
support).
C151161 FAC062-I Feel Ill FAC062-I Feel Ill Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Physical Well-Being: I feel Feel Ill
ill.
C151195 FAC062-I Feel Motivated FAC062-I Feel Motivated Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
to Do Things to Do Things Response Modifiers Version 4 - Additional Concerns- Feel Motivated to Do
Mental: I feel motivated to do things. Things
C151173 FAC062-I Feel Nervous FAC062-I Feel Nervous Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Emotional Well-Being: I Feel Nervous
feel nervous.
C151170 FAC062-I Feel Sad FAC062-I Feel Sad Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Emotional Well-Being: I Feel Sad
feel sad.
C151184 FAC062-I Feel Weak All FAC062-I Feel Weak All Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Over Over Response Modifiers Version 4 - Additional Concerns- Feel Weak All Over
Physical: I feel weak all over.
page 571 of 1925

C150777 FAC062TN
Code Value
C151193 FAC062-I Get Annoyed FAC062-I Get Annoyed Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Easily Easily Response Modifiers Version 4 - Additional Concerns- Get Annoyed Easily
Mental: I get annoyed easily.
C151192 FAC062-I Get Depressed FAC062-I Get Depressed Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Easily Easily Response Modifiers Version 4 - Additional Concerns- Get Depressed Easily
Mental: I get depressed easily.
C151165 FAC062-I Get Support FAC062-I Get Support Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
From My Friends From My Friends Response Modifiers Version 4 - Social/Family Well-Being: Get Support From My
I get support from my friends. Friends
C151183 FAC062-I Get Tired Easily FAC062-I Get Tired Easily Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Additional Concerns- Get Tired Easily
Physical: I get tired easily.
C151185 FAC062-I Have a Good FAC062-I Have a Good Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Appetite Appetite Response Modifiers Version 4 - Additional Concerns- Have a Good Appetite
Physical: I have a good appetite.
C151156 FAC062-I Have a Lack of FAC062-I Have a Lack of Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Energy Energy Response Modifiers Version 4 - Physical Well-Being: I Have a Lack of Energy
C151179 FAC062-I Have Accepted FAC062-I Have Accepted Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
My Illness My Illness Response Modifiers Version 4 - Functional Well-Being: I Have Accepted My Illness
have accepted my illness.
C151194 FAC062-I Have Emotional FAC062-I Have Emotional Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Ups and Downs Ups and Downs Response Modifiers Version 4 - Additional Concerns- Have Emotional Ups and
Mental: I have emotional ups and downs. Downs
C151157 FAC062-I Have Nausea FAC062-I Have Nausea Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Physical Well-Being: I Have Nausea
have nausea.
C151159 FAC062-I Have Pain FAC062-I Have Pain Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Response Modifiers Version 4 - Physical Well-Being: I Have Pain
have pain.
C151186 FAC062-I Have Pain in My FAC062-I Have Pain in My Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Joints Joints Response Modifiers Version 4 - Additional Concerns- Have Pain in My Joints
Physical: I have pain in my joints.
C151190 FAC062-I Have Trouble FAC062-I Have Trouble Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Concentrating Concentrating Response Modifiers Version 4 - Additional Concerns- Have Trouble
Mental: I have trouble concentrating. Concentrating
C151191 FAC062-I Have Trouble FAC062-I Have Trouble Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Remembering Things Remembering Things Response Modifiers Version 4 - Additional Concerns- Have Trouble
Mental: I have trouble remembering things. Remembering Things
C151174 FAC062-I Worry About FAC062-I Worry About Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - I
Dying Dying Response Modifiers Version 4 - Emotional Well-Being: I Worry About Dying
worry about dying.
C151172 FAC062-Losing Hope FAC062-Losing Hope Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Against Illness Against Illness Response Modifiers Version 4 - Emotional Well-Being: I Losing Hope Against
am losing hope in the fight against my illness. Illness
C151166 FAC062-My Family Has FAC062-My Family Has Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - My
Accepted My Illness Accepted My Illness Response Modifiers Version 4 - Social/Family Well-Being: Family Has Accepted My
My family has accepted my illness. Illness
C151177 FAC062-My Work Is FAC062-My Work Is Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 - My
Fulfilling Fulfilling Response Modifiers Version 4 - Functional Well-Being: My Work Is Fulfilling
work (include work at home) is fulfilling.
C151167 FAC062-Satisfied FAC062-Satisfied Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -

Communication Illness Communication Illness Response Modifiers Version 4 - Social/Family Well-Being: Satisfied Communication
I am satisfied with family communication about my Illness
illness.
C151171 FAC062-Satisfied With FAC062-Satisfied With Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
How I Am Coping How I Am Coping Response Modifiers Version 4 - Emotional Well-Being: I Satisfied With How I Am
am satisfied with how I am coping with my illness. Coping
C151158 FAC062-Trouble Meeting FAC062-Trouble Meeting Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -
Needs of Family Needs of Family Response Modifiers Version 4 - Physical Well-Being: Trouble Meeting Needs of
Because of my physical condition, I have trouble meeting Family
the needs of my family.
page 572 of 1925

C150777 FAC062TN
Code Value
C151175 FAC062-Worry My FAC062-Worry My Functional Assessment of Cancer Therapy-Biologic FACT-BRM Version 4 -

Condition Will Get Worse Condition Will Get Worse Response Modifiers Version 4 - Emotional Well-Being: I Worry My Condition Will
worry that my condition will get worse. Get Worse
page 573 of 1925

FAC063TC (Functional Assessment of Cancer Therapy-Taxane Version 4 Questionnaire Test Code)
C150776 FAC063TC
Code Value
C151113 FAC06301 FAC063-I Have a Lack of Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Energy 4 - Physical Well-Being: I have a lack of energy. I Have a Lack of Energy
C151114 FAC06302 FAC063-I Have Nausea Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Physical Well-Being: I have nausea. I Have Nausea
C151115 FAC06303 FAC063-Trouble Meeting Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Needs of Family 4 - Physical Well-Being: Because of my physical Trouble Meeting Needs of
C151116 FAC06304 FAC063-I Have Pain Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Physical Well-Being: I have pain. I Have Pain
C151117 FAC06305 FAC063-Bothered by Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Treatment Side Effect 4 - Physical Well-Being: I am bothered by side effects of Bothered by Treatment
C151118 FAC06306 FAC063-I Feel Ill Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Physical Well-Being: I feel ill. I Feel Ill
C151119 FAC06307 FAC063-I Am Forced to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Spend Time in Bed 4 - Physical Well-Being: I am forced to spend time in bed. I Am Forced to Spend
Time in Bed
C151120 FAC06308 FAC063-I Feel Close to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
My Friends 4 - Social/Family Well-Being: I feel close to my friends. I Feel Close to My Friends
C151121 FAC06309 FAC063-Get Emotional Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Support From Family 4 - Social/Family Well-Being: I get emotional support Get Emotional Support
from my family. From Family
C151122 FAC06310 FAC063-I Get Support Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
From My Friends 4 - Social/Family Well-Being: I get support from my I Get Support From My
friends. Friends
C151123 FAC06311 FAC063-My Family Has Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Accepted My Illness 4 - Social/Family Well-Being: My family has accepted my My Family Has Accepted
illness. My Illness
C151124 FAC06312 FAC063-Satisfied Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Communication Illness 4 - Social/Family Well-Being: I am satisfied with family Satisfied Communication
C151125 FAC06313 FAC063-I Feel Close to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
My Partner 4 - Social/Family Well-Being: I feel close to my partner I Feel Close to My Partner
C151126 FAC06314 FAC063-I Am Satisfied Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
With My Sex Life 4 - Social/Family Well-Being: I am satisfied with my sex I Am Satisfied With My
life. Sex Life
C151127 FAC06315 FAC063-I Feel Sad Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Emotional Well-Being: I feel sad. I Feel Sad
C151128 FAC06316 FAC063-Satisfied With Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
How I Am Coping 4 - Emotional Well-Being: I am satisfied with how I am Satisfied With How I Am
C151129 FAC06317 FAC063-Losing Hope Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Against Illness 4 - Emotional Well-Being: I am losing hope in the fight Losing Hope Against
C151130 FAC06318 FAC063-I Feel Nervous Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Emotional Well-Being: I feel nervous. I Feel Nervous
C151131 FAC06319 FAC063-I Worry About Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Dying 4 - Emotional Well-Being: I worry about dying. I Worry About Dying
C151132 FAC06320 FAC063-Worry My Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Condition Will Get Worse 4 - Emotional Well-Being: I worry that my condition will Worry My Condition Will
get worse. Get Worse
C151133 FAC06321 FAC063-I Am Able to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Work 4 - Functional Well-Being: I am able to work (include I Am Able to Work
work at home).
C151134 FAC06322 FAC063-My Work Is Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Fulfilling 4 - Functional Well-Being: My work (include work at My Work Is Fulfilling
page 574 of 1925

C150776 FAC063TC
Code Value
C151135 FAC06323 FAC063-I Am Able to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Enjoy Life 4 - Functional Well-Being: I am able to enjoy life. I Am Able to Enjoy Life
C151136 FAC06324 FAC063-I Have Accepted Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
My Illness 4 - Functional Well-Being: I have accepted my illness. I Have Accepted My
Illness
C151137 FAC06325 FAC063-I Am Sleeping Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Well 4 - Functional Well-Being: I am sleeping well. I Am Sleeping Well
C151138 FAC06326 FAC063-Enjoy Things I Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Usually Do for Fun 4 - Functional Well-Being: I am enjoying the things I Enjoy Things I Usually Do
usually do for fun. for Fun
C151139 FAC06327 FAC063-Content With Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Quality of My Life 4 - Functional Well-Being: I am content with the quality Content With Quality of
C151140 FAC06328 FAC063-Numbness or Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Tingling in My Hands 4 - Additional Concerns: I have numbness or tingling in Numbness or Tingling in
my hands. My Hands
C151141 FAC06329 FAC063-Numbness or Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Tingling in My Feet 4 - Additional Concerns: I have numbness or tingling in Numbness or Tingling in
my feet. My Feet
C151142 FAC06330 FAC063-I Feel Discomfort Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
in My Hands 4 - Additional Concerns: I feel discomfort in my hands. I Feel Discomfort in My
Hands
C151143 FAC06331 FAC063-I Feel Discomfort Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
in My Feet 4 - Additional Concerns: I feel discomfort in my feet. I Feel Discomfort in My
Feet
C151144 FAC06332 FAC063-Have Joint Pain Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
or Muscle Cramps 4 - Additional Concerns: I have joint pain or muscle Have Joint Pain or Muscle
cramps. Cramps
C151145 FAC06333 FAC063-I Feel Weak All Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Over 4 - Additional Concerns: I feel weak all over. I Feel Weak All Over
C151146 FAC06334 FAC063-I Have Trouble Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Hearing 4 - Additional Concerns: I have trouble hearing. I Have Trouble Hearing
C151147 FAC06335 FAC063-Get Ringing or Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Buzzing in My Ears 4 - Additional Concerns: I get a ringing or buzzing in my Get Ringing or Buzzing in
ears. My Ears
Buttoning Buttons 4 - Additional Concerns: I have trouble buttoning buttons. I Have Trouble Buttoning
Buttons
C151149 FAC06337 FAC063-Trouble Feeling Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Shape of Objects 4 - Additional Concerns: I have trouble feeling the shape Trouble Feeling Shape of
of small objects when they are in my hand. Objects
Walking 4 - Additional Concerns: I have trouble walking. I Have Trouble Walking
C151151 FAC06339 FAC063-I Feel Bloated Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Additional Concerns: I feel bloated. I Feel Bloated
C151152 FAC06340 FAC063-My Hands Are Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Swollen 4 - Additional Concerns: My hands are swollen. My Hands Are Swollen
C151153 FAC06341 FAC063-My Legs or Feet Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Are Swollen 4 - Additional Concerns: My legs or feet are swollen. My Legs or Feet Are
Swollen
C151154 FAC06342 FAC063-I Have Pain in My Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Fingertips 4 - Additional Concerns: I have pain in my fingertips. I Have Pain in My
Fingertips
C151155 FAC06343 FAC063-Bothered by My Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Hands/Nails Look 4 - Additional Concerns: I am bothered by the way my Bothered by My
hands or nails look. Hands/Nails Look
page 575 of 1925

FAC063TN (Functional Assessment of Cancer Therapy-Taxane Version 4 Questionnaire Test Name)
C150775 FAC063TN
Code Value
C151155 FAC063-Bothered by My FAC063-Bothered by My Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Hands/Nails Look Hands/Nails Look 4 - Additional Concerns: I am bothered by the way my Bothered by My
hands or nails look. Hands/Nails Look
C151117 FAC063-Bothered by FAC063-Bothered by Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Treatment Side Effect Treatment Side Effect 4 - Physical Well-Being: I am bothered by side effects of Bothered by Treatment
C151139 FAC063-Content With FAC063-Content With Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Quality of My Life Quality of My Life 4 - Functional Well-Being: I am content with the quality Content With Quality of
C151138 FAC063-Enjoy Things I FAC063-Enjoy Things I Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Usually Do for Fun Usually Do for Fun 4 - Functional Well-Being: I am enjoying the things I Enjoy Things I Usually Do
usually do for fun. for Fun
C151121 FAC063-Get Emotional FAC063-Get Emotional Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Support From Family Support From Family 4 - Social/Family Well-Being: I get emotional support Get Emotional Support
from my family. From Family
C151147 FAC063-Get Ringing or FAC063-Get Ringing or Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Buzzing in My Ears Buzzing in My Ears 4 - Additional Concerns: I get a ringing or buzzing in my Get Ringing or Buzzing in
ears. My Ears
C151144 FAC063-Have Joint Pain FAC063-Have Joint Pain Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
or Muscle Cramps or Muscle Cramps 4 - Additional Concerns: I have joint pain or muscle Have Joint Pain or Muscle
cramps. Cramps
C151135 FAC063-I Am Able to FAC063-I Am Able to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Enjoy Life Enjoy Life 4 - Functional Well-Being: I am able to enjoy life. I Am Able to Enjoy Life
C151133 FAC063-I Am Able to FAC063-I Am Able to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Work Work 4 - Functional Well-Being: I am able to work (include I Am Able to Work
work at home).
C151119 FAC063-I Am Forced to FAC063-I Am Forced to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Spend Time in Bed Spend Time in Bed 4 - Physical Well-Being: I am forced to spend time in bed. I Am Forced to Spend
Time in Bed
C151126 FAC063-I Am Satisfied FAC063-I Am Satisfied Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
With My Sex Life With My Sex Life 4 - Social/Family Well-Being: I am satisfied with my sex I Am Satisfied With My
life. Sex Life
C151137 FAC063-I Am Sleeping FAC063-I Am Sleeping Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Well Well 4 - Functional Well-Being: I am sleeping well. I Am Sleeping Well
C151151 FAC063-I Feel Bloated FAC063-I Feel Bloated Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Additional Concerns: I feel bloated. I Feel Bloated
C151120 FAC063-I Feel Close to FAC063-I Feel Close to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
My Friends My Friends 4 - Social/Family Well-Being: I feel close to my friends. I Feel Close to My Friends
C151125 FAC063-I Feel Close to FAC063-I Feel Close to Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
My Partner My Partner 4 - Social/Family Well-Being: I feel close to my partner I Feel Close to My Partner
C151143 FAC063-I Feel Discomfort FAC063-I Feel Discomfort Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
in My Feet in My Feet 4 - Additional Concerns: I feel discomfort in my feet. I Feel Discomfort in My
Feet
C151142 FAC063-I Feel Discomfort FAC063-I Feel Discomfort Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
in My Hands in My Hands 4 - Additional Concerns: I feel discomfort in my hands. I Feel Discomfort in My
Hands
C151118 FAC063-I Feel Ill FAC063-I Feel Ill Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Physical Well-Being: I feel ill. I Feel Ill
C151130 FAC063-I Feel Nervous FAC063-I Feel Nervous Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Emotional Well-Being: I feel nervous. I Feel Nervous
C151127 FAC063-I Feel Sad FAC063-I Feel Sad Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Emotional Well-Being: I feel sad. I Feel Sad
C151145 FAC063-I Feel Weak All FAC063-I Feel Weak All Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Over Over 4 - Additional Concerns: I feel weak all over. I Feel Weak All Over
C151122 FAC063-I Get Support FAC063-I Get Support Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
From My Friends From My Friends 4 - Social/Family Well-Being: I get support from my I Get Support From My
friends. Friends
page 576 of 1925

C150775 FAC063TN
Code Value
C151113 FAC063-I Have a Lack of FAC063-I Have a Lack of Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Energy Energy 4 - Physical Well-Being: I have a lack of energy. I Have a Lack of Energy
C151136 FAC063-I Have Accepted FAC063-I Have Accepted Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
My Illness My Illness 4 - Functional Well-Being: I have accepted my illness. I Have Accepted My
Illness
C151114 FAC063-I Have Nausea FAC063-I Have Nausea Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Physical Well-Being: I have nausea. I Have Nausea
C151116 FAC063-I Have Pain FAC063-I Have Pain Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
4 - Physical Well-Being: I have pain. I Have Pain
C151154 FAC063-I Have Pain in My FAC063-I Have Pain in My Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Fingertips Fingertips 4 - Additional Concerns: I have pain in my fingertips. I Have Pain in My
Fingertips
C151148 FAC063-I Have Trouble FAC063-I Have Trouble Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Buttoning Buttons Buttoning Buttons 4 - Additional Concerns: I have trouble buttoning buttons. I Have Trouble Buttoning
Buttons
Hearing Hearing 4 - Additional Concerns: I have trouble hearing. I Have Trouble Hearing
Walking Walking 4 - Additional Concerns: I have trouble walking. I Have Trouble Walking
C151131 FAC063-I Worry About FAC063-I Worry About Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Dying Dying 4 - Emotional Well-Being: I worry about dying. I Worry About Dying
C151129 FAC063-Losing Hope FAC063-Losing Hope Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Against Illness Against Illness 4 - Emotional Well-Being: I am losing hope in the fight Losing Hope Against
C151123 FAC063-My Family Has FAC063-My Family Has Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Accepted My Illness Accepted My Illness 4 - Social/Family Well-Being: My family has accepted my My Family Has Accepted
illness. My Illness
C151152 FAC063-My Hands Are FAC063-My Hands Are Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Swollen Swollen 4 - Additional Concerns: My hands are swollen. My Hands Are Swollen
C151153 FAC063-My Legs or Feet FAC063-My Legs or Feet Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Are Swollen Are Swollen 4 - Additional Concerns: My legs or feet are swollen. My Legs or Feet Are
Swollen
C151134 FAC063-My Work Is FAC063-My Work Is Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Fulfilling Fulfilling 4 - Functional Well-Being: My work (include work at My Work Is Fulfilling
C151141 FAC063-Numbness or FAC063-Numbness or Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Tingling in My Feet Tingling in My Feet 4 - Additional Concerns: I have numbness or tingling in Numbness or Tingling in
my feet. My Feet
C151140 FAC063-Numbness or FAC063-Numbness or Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Tingling in My Hands Tingling in My Hands 4 - Additional Concerns: I have numbness or tingling in Numbness or Tingling in
my hands. My Hands
C151124 FAC063-Satisfied FAC063-Satisfied Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Communication Illness Communication Illness 4 - Social/Family Well-Being: I am satisfied with family Satisfied Communication
C151128 FAC063-Satisfied With FAC063-Satisfied With Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
How I Am Coping How I Am Coping 4 - Emotional Well-Being: I am satisfied with how I am Satisfied With How I Am
C151149 FAC063-Trouble Feeling FAC063-Trouble Feeling Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Shape of Objects Shape of Objects 4 - Additional Concerns: I have trouble feeling the shape Trouble Feeling Shape of
of small objects when they are in my hand. Objects
C151115 FAC063-Trouble Meeting FAC063-Trouble Meeting Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Needs of Family Needs of Family 4 - Physical Well-Being: Because of my physical Trouble Meeting Needs of
C151132 FAC063-Worry My FAC063-Worry My Functional Assessment of Cancer Therapy-Taxane Version FACT-Taxane Version 4 -
Condition Will Get Worse Condition Will Get Worse 4 - Emotional Well-Being: I worry that my condition will Worry My Condition Will
get worse. Get Worse
page 577 of 1925

FAC070TC (Functional Assessment of Chronic Illness Therapy-Fatigue 13-Item Scale Version 4
C147544 FAC070TC
Code Value
C147673 FAC07001 FAC070-I Feel Fatigued Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
13-Item Scale Version 4 - I feel fatigued. Version 4 - I Feel
Fatigued
C147674 FAC07002 FAC070-I Feel Weak All Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Over 13-Item Scale Version 4 - I feel weak all over. Version 4 - I Feel Weak
All Over
C147675 FAC07003 FAC070-I Feel Listless Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
13-Item Scale Version 4 - I feel listless ("washed out"). Version 4 - I Feel Listless
C147676 FAC07004 FAC070-I Feel Tired Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
13-Item Scale Version 4 - I feel tired. Version 4 - I Feel Tired
C147677 FAC07005 FAC070-Trouble Starting Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Things 13-Item Scale Version 4 - I have trouble starting things Version 4 - Trouble
because I am tired. Starting Things
C147678 FAC07006 FAC070-Trouble Finishing Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Things 13-Item Scale Version 4 - I have trouble finishing things Version 4 - Trouble
because I am tired. Finishing Things
C147679 FAC07007 FAC070-I Have Energy Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
13-Item Scale Version 4 - I have energy. Version 4 - I Have Energy
C147680 FAC07008 FAC070-Able to Do My Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Usual Activities 13-Item Scale Version 4 - I am able to do my usual Version 4 - Able to Do My
activities. Usual Activities
C147681 FAC07009 FAC070-I Need to Sleep Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
During the Day 13-Item Scale Version 4 - I need to sleep during the day. Version 4 - I Need to
Sleep During the Day
C147682 FAC07010 FAC070-I Am Too Tired to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Eat 13-Item Scale Version 4 - I am too tired to eat. Version 4 - I Am Too
Tired to Eat
C147683 FAC07011 FAC070-Need Help Doing Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Usual Activities 13-Item Scale Version 4 - I need help doing my usual Version 4 - Need Help
activities. Doing Usual Activities
C147684 FAC07012 FAC070-Frustrated by Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Being Too Tired 13-Item Scale Version 4 - I am frustrated by being too Version 4 - Frustrated by
tired to do the things I want to do. Being Too Tired
C147685 FAC07013 FAC070-Limit Social Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Activity, I am Tired 13-Item Scale Version 4 - I have to limit my social Version 4 - Limit Social
activity because I am tired. Activity, I am Tired
page 578 of 1925

FAC070TN (Functional Assessment of Chronic Illness Therapy-Fatigue 13-Item Scale Version 4
C147543 FAC070TN
Code Value
C147680 FAC070-Able to Do My FAC070-Able to Do My Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Usual Activities Usual Activities 13-Item Scale Version 4 - I am able to do my usual Version 4 - Able to Do My
activities. Usual Activities
C147684 FAC070-Frustrated by FAC070-Frustrated by Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Being Too Tired Being Too Tired 13-Item Scale Version 4 - I am frustrated by being too Version 4 - Frustrated by
tired to do the things I want to do. Being Too Tired
C147682 FAC070-I Am Too Tired to FAC070-I Am Too Tired to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Eat Eat 13-Item Scale Version 4 - I am too tired to eat. Version 4 - I Am Too
Tired to Eat
C147673 FAC070-I Feel Fatigued FAC070-I Feel Fatigued Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
13-Item Scale Version 4 - I feel fatigued. Version 4 - I Feel
Fatigued
C147675 FAC070-I Feel Listless FAC070-I Feel Listless Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
13-Item Scale Version 4 - I feel listless ("washed out"). Version 4 - I Feel Listless
C147676 FAC070-I Feel Tired FAC070-I Feel Tired Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
13-Item Scale Version 4 - I feel tired. Version 4 - I Feel Tired
C147674 FAC070-I Feel Weak All FAC070-I Feel Weak All Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Over Over 13-Item Scale Version 4 - I feel weak all over. Version 4 - I Feel Weak
All Over
C147679 FAC070-I Have Energy FAC070-I Have Energy Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
13-Item Scale Version 4 - I have energy. Version 4 - I Have Energy
C147681 FAC070-I Need to Sleep FAC070-I Need to Sleep Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
During the Day During the Day 13-Item Scale Version 4 - I need to sleep during the day. Version 4 - I Need to
Sleep During the Day
C147685 FAC070-Limit Social FAC070-Limit Social Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Activity, I am Tired Activity, I am Tired 13-Item Scale Version 4 - I have to limit my social Version 4 - Limit Social
activity because I am tired. Activity, I am Tired
C147683 FAC070-Need Help Doing FAC070-Need Help Doing Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Usual Activities Usual Activities 13-Item Scale Version 4 - I need help doing my usual Version 4 - Need Help
activities. Doing Usual Activities
C147678 FAC070-Trouble Finishing FAC070-Trouble Finishing Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Things Things 13-Item Scale Version 4 - I have trouble finishing things Version 4 - Trouble
because I am tired. Finishing Things
C147677 FAC070-Trouble Starting FAC070-Trouble Starting Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-Fatigue 13-Item
Things Things 13-Item Scale Version 4 - I have trouble starting things Version 4 - Trouble
because I am tired. Starting Things
page 579 of 1925

FAC071TC (Functional Assessment of Chronic Illness Therapy-Fatigue Version 4 Questionnaire Test
Code)
C129088 FAC071TC
Code Value
C129111 FAC07101 FAC071-I Have a Lack of Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
C129112 FAC07102 FAC071-I Have Nausea Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
C129113 FAC07103 FAC071-Trouble Meeting Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129114 FAC07104 FAC071-I Have Pain Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
C129115 FAC07105 FAC071-Bothered by Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129116 FAC07106 FAC071-I Feel Ill Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
C129117 FAC07107 FAC071-I Am Forced to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
time in bed. Bed
C129118 FAC07108 FAC071-I Feel Close to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
friends.
C129119 FAC07109 FAC071-Get Emotional Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Get
C129120 FAC07110 FAC071-I Get Support Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Get
my friends.
C129121 FAC07111 FAC071-My Family Has Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - My
C129122 FAC07112 FAC071-Satisfied Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied Family
family communication about my illness. Communication of Illness
C129123 FAC07113 FAC071-I Feel Close to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
C129124 FAC07114 FAC071-I Am Satisfied Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
my sex life.
C129125 FAC07115 FAC071-I Feel Sad Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
C129126 FAC07116 FAC071-Satisfied With Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129127 FAC07117 FAC071-Losing Hope Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129128 FAC07118 FAC071-I Feel Nervous Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
C129129 FAC07119 FAC071-I Worry About Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
C129130 FAC07120 FAC071-Worry My Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129131 FAC07121 FAC071-I Am Able to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
page 580 of 1925

C129088 FAC071TC
Code Value
C129132 FAC07122 FAC071-My Work Is Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - My
C129133 FAC07123 FAC071-I Am Able to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
C129134 FAC07124 FAC071-I Have Accepted Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
illness.
C129135 FAC07125 FAC071-I Am Sleeping Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
C129136 FAC07126 FAC071-Enjoy Things I Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Enjoy
C129137 FAC07127 FAC071-Content With Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129138 FAC07128 FAC071-I Feel Fatigued Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
Version 4 - Additional Concerns: I feel fatigued. Fatigued
C129139 FAC07129 FAC071-I Feel Weak All Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
Over Version 4 - Additional Concerns: I feel weak all over. Weak All Over
C129140 FAC07130 FAC071-I Feel Listless Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
Version 4 - Additional Concerns: I feel listless ('washed Listless
out').
C129141 FAC07131 FAC071-I Feel Tired Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
Version 4 - Additional Concerns: I feel tired. Tired
C129142 FAC07132 FAC071-Trouble Starting Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
Things Version 4 - Additional Concerns: I have trouble starting Trouble Starting Things
things because I am tired.
C129143 FAC07133 FAC071-Trouble Finishing Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
Things Version 4 - Additional Concerns: I have trouble finishing Trouble Finishing Things
C129144 FAC07134 FAC071-I Have Energy Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
Version 4 - Additional Concerns: I have energy. Have Energy
C129145 FAC07135 FAC071-Able to Do My Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Able
Usual Activities Version 4 - Additional Concerns: I am able to do my usual to Do My Usual Activities
activities.
C129146 FAC07136 FAC071-I Need to Sleep Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
During the Day Version 4 - Additional Concerns: I need to sleep during Need to Sleep During the
the day. Day
C129147 FAC07137 FAC071-I Am Too Tired to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
Eat Version 4 - Additional Concerns: I am too tired to eat. Too Tired to Eat
C129148 FAC07138 FAC071-Need Help Doing Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Need
Usual Activities Version 4 - Additional Concerns: I need help doing my Help Doing Usual
usual activities. Activities
C129149 FAC07139 FAC071-Frustrated by Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
Being Too Tired Version 4 - Additional Concerns: I am frustrated by being Frustrated by Being Too
too tired to do the things I want to do. Tired
C129150 FAC07140 FAC071-Limit Social Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Limit
Activity, I am Tired Version 4 - Additional Concerns: I have to limit my social Social Activity, I am Tired
activity because I am tired.
page 581 of 1925

FAC071TN (Functional Assessment of Chronic Illness Therapy-Fatigue Version 4 Questionnaire Test
Name)
C129087 FAC071TN
Code Value
C129145 FAC071-Able to Do My FAC071-Able to Do My Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Able
Usual Activities Usual Activities Version 4 - Additional Concerns: I am able to do my usual to Do My Usual Activities
activities.
C129115 FAC071-Bothered by FAC071-Bothered by Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129137 FAC071-Content With FAC071-Content With Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129136 FAC071-Enjoy Things I FAC071-Enjoy Things I Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Enjoy
C129149 FAC071-Frustrated by FAC071-Frustrated by Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
Being Too Tired Being Too Tired Version 4 - Additional Concerns: I am frustrated by being Frustrated by Being Too
too tired to do the things I want to do. Tired
C129119 FAC071-Get Emotional FAC071-Get Emotional Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Get
C129133 FAC071-I Am Able to FAC071-I Am Able to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
C129131 FAC071-I Am Able to FAC071-I Am Able to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
C129117 FAC071-I Am Forced to FAC071-I Am Forced to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
time in bed. Bed
C129124 FAC071-I Am Satisfied FAC071-I Am Satisfied Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
my sex life.
C129135 FAC071-I Am Sleeping FAC071-I Am Sleeping Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
C129147 FAC071-I Am Too Tired to FAC071-I Am Too Tired to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Am
Eat Eat Version 4 - Additional Concerns: I am too tired to eat. Too Tired to Eat
C129118 FAC071-I Feel Close to FAC071-I Feel Close to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
friends.
C129123 FAC071-I Feel Close to FAC071-I Feel Close to Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
C129138 FAC071-I Feel Fatigued FAC071-I Feel Fatigued Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
Version 4 - Additional Concerns: I feel fatigued. Fatigued
C129116 FAC071-I Feel Ill FAC071-I Feel Ill Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
C129140 FAC071-I Feel Listless FAC071-I Feel Listless Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
Version 4 - Additional Concerns: I feel listless ('washed Listless
out').
C129128 FAC071-I Feel Nervous FAC071-I Feel Nervous Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
C129125 FAC071-I Feel Sad FAC071-I Feel Sad Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
C129141 FAC071-I Feel Tired FAC071-I Feel Tired Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
Version 4 - Additional Concerns: I feel tired. Tired
C129139 FAC071-I Feel Weak All FAC071-I Feel Weak All Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Feel
Over Over Version 4 - Additional Concerns: I feel weak all over. Weak All Over
C129120 FAC071-I Get Support FAC071-I Get Support Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I Get
my friends.
page 582 of 1925

C129087 FAC071TN
Code Value
C129111 FAC071-I Have a Lack of FAC071-I Have a Lack of Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
C129134 FAC071-I Have Accepted FAC071-I Have Accepted Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
illness.
C129144 FAC071-I Have Energy FAC071-I Have Energy Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
Version 4 - Additional Concerns: I have energy. Have Energy
C129112 FAC071-I Have Nausea FAC071-I Have Nausea Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
C129114 FAC071-I Have Pain FAC071-I Have Pain Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
C129146 FAC071-I Need to Sleep FAC071-I Need to Sleep Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
During the Day During the Day Version 4 - Additional Concerns: I need to sleep during Need to Sleep During the
the day. Day
C129129 FAC071-I Worry About FAC071-I Worry About Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - I
C129150 FAC071-Limit Social FAC071-Limit Social Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Limit
Activity, I am Tired Activity, I am Tired Version 4 - Additional Concerns: I have to limit my social Social Activity, I am Tired
activity because I am tired.
C129127 FAC071-Losing Hope FAC071-Losing Hope Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129121 FAC071-My Family Has FAC071-My Family Has Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - My
C129132 FAC071-My Work Is FAC071-My Work Is Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - My
C129148 FAC071-Need Help Doing FAC071-Need Help Doing Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 - Need
Usual Activities Usual Activities Version 4 - Additional Concerns: I need help doing my Help Doing Usual
usual activities. Activities
C129122 FAC071-Satisfied FAC071-Satisfied Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
Communication Illness Communication Illness Version 4 - Social/Family Well-Being: I am satisfied with Satisfied Family
family communication about my illness. Communication of Illness
C129126 FAC071-Satisfied With FAC071-Satisfied With Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129143 FAC071-Trouble Finishing FAC071-Trouble Finishing Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
Things Things Version 4 - Additional Concerns: I have trouble finishing Trouble Finishing Things
C129113 FAC071-Trouble Meeting FAC071-Trouble Meeting Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
C129142 FAC071-Trouble Starting FAC071-Trouble Starting Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
Things Things Version 4 - Additional Concerns: I have trouble starting Trouble Starting Things
C129130 FAC071-Worry My FAC071-Worry My Functional Assessment of Chronic Illness Therapy-Fatigue FACIT-F Version 4 -
page 583 of 1925

FAC084TC (Functional Assessment of Chronic Illness Therapy-Dyspnea 10 Item Short Form
C147542 FAC084TC
Code Value
C147643 FAC08401 FAC084-Part I: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Without Help Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Dressing Without Help
activities?: Dressing yourself without help.
C147644 FAC08402 FAC084-Part I: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Dressing Why Not
activities?: Dressing yourself without help. Please indicate
why you did not do this in the past 7 days.
C147645 FAC08403 FAC084-Part I: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Steps Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these 50 Steps
activities?: Walking 50 steps/paces on flat ground at a
normal speed without stopping.
C147646 FAC08404 FAC084-Part I: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Steps Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these 50 Steps Why Not
normal speed without stopping. Please indicate why you
did not do this in the past 7 days.
C147647 FAC08405 FAC084-Part I: Walk Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Stairs Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these Up 20 Stairs
activities?: Walking up 20 stairs (2 flights) without
stopping.
C147648 FAC08406 FAC084-Part I: Walk Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Stairs Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these Up 20 Stairs Why Not
stopping. Please indicate why you did not do this in the
past 7 days.
C147649 FAC08407 FAC084-Part I: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Meals Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Preparing Meals
activities?: Preparing Meals.
C147650 FAC08408 FAC084-Part I: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Meals Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Preparing Meals Why Not
activities?: Preparing Meals. Please indicate why you did
not do this in the past 7 days.
C147651 FAC08409 FAC084-Part I: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Dishes Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Washing Dishes
activities?: Washing dishes.
C147652 FAC08410 FAC084-Part I: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Dishes Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Washing Dishes Why Not
activities?: Washing dishes. Please indicate why you did
C147653 FAC08411 FAC084-Part I: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Sweeping/Mopping Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Sweeping/Mopping
activities?: Sweeping or mopping.
C147654 FAC08412 FAC084-Part I: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Sweeping/Mopping Why Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
Not days, how short of breath did you get with each of these Sweeping/Mopping Why
activities?: Sweeping or mopping. Please indicate why Not
you did not do this in the past 7 days.
C147655 FAC08413 FAC084-Part I: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Bed Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Making a Bed
activities?: Making a bed.
page 584 of 1925

C147542 FAC084TC
Code Value
C147656 FAC08414 FAC084-Part I: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Bed Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Making a Bed Why Not
activities?: Making a bed. Please indicate why you did not
do this in the past 7 days.
C147657 FAC08415 FAC084-Part I: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Lifting 10-20 Lbs
activities?: Lifting something weighing 10-20 lbs (about
4.5-9kg, like a large bag of groceries).
C147658 FAC08416 FAC084-Part I: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Lifting 10-20 Lbs Why Not
4.5-9kg, like a large bag of groceries). Please indicate
C147659 FAC08417 FAC084-Part I: Carry 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Carry
days, how short of breath did you get with each of these 10-20 Lbs
activities?: Carrying something weighing 10-20 lbs (about
4.5-9kg, like a large bag of groceries) from one room to
another.
C147660 FAC08418 FAC084-Part I: Carry 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Carry
days, how short of breath did you get with each of these 10-20 Lbs Why Not
another. Please indicate why you did not do this in the
past 7 days.
C147661 FAC08419 FAC084-Part I: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
1/2 Mile Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these for 1/2 Mile
activities?: Walking (faster than your usual speed) for 1/2
mile (almost 1 km) without stopping.
C147662 FAC08420 FAC084-Part I: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
1/2 Mile Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these for 1/2 Mile Why Not
mile (almost 1 km) without stopping. Please indicate why
C147663 FAC08421 FAC084-Part II: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Without Help Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Dressing Without Help
past 7 days, rate the amount of difficulty you had when
doing the following activities: Dressing yourself without
help.
C147664 FAC08422 FAC084-Part II: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Steps Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Walk 50 Steps
doing the following activities: Walking 50 steps/paces on
flat ground at a normal speed without stopping.
C147665 FAC08423 FAC084-Part II: Walk Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Stairs Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Walk Up 20 Stairs
doing the following activities: Walking up 20 stairs (2
flights) without stopping.
C147666 FAC08424 FAC084-Part II: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Meals Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Preparing Meals
doing the following activities: Preparing meals.
C147667 FAC08425 FAC084-Part II: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Dishes Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Washing Dishes
doing the following activities: Washing dishes.
C147668 FAC08426 FAC084-Part II: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Sweeping/Mopping Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Sweeping/Mopping
doing the following activities: Sweeping or mopping.
page 585 of 1925

C147542 FAC084TC
Code Value
C147669 FAC08427 FAC084-Part II: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Bed Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Making a Bed
doing the following activities: Making a bed.
C147670 FAC08428 FAC084-Part II: Lifting Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
10-20 Lbs Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Lifting 10-20 Lbs
doing the following activities: Lifting something weighing
10-20 lbs (about 4.5-9kg, like a large bag of groceries).
C147671 FAC08429 FAC084-Part II: Carry 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Carry 10-20 Lbs
doing the following activities: Carrying something
weighing 10-20 lbs (about 4.5-9kg, like a large bag of
groceries) from one room to another.
C147672 FAC08430 FAC084-Part II: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
1/2 Mile Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Walk for 1/2 Mile
doing the following activities: Walking (faster than your
usual speed) for 1/2 mile (almost 1 km) without stopping.
page 586 of 1925

FAC084TN (Functional Assessment of Chronic Illness Therapy-Dyspnea 10 Item Short Form
C147541 FAC084TN
Code Value
C147659 FAC084-Part I: Carry 10- FAC084-Part I: Carry 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs 20 Lbs Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Carry
days, how short of breath did you get with each of these 10-20 Lbs
another.
C147660 FAC084-Part I: Carry 10- FAC084-Part I: Carry 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs Why Not 20 Lbs Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Carry
days, how short of breath did you get with each of these 10-20 Lbs Why Not
another. Please indicate why you did not do this in the
past 7 days.
C147644 FAC084-Part I: Dressing FAC084-Part I: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Why Not Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Dressing Why Not
activities?: Dressing yourself without help. Please indicate
C147643 FAC084-Part I: Dressing FAC084-Part I: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Without Help Without Help Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Dressing Without Help
activities?: Dressing yourself without help.
C147657 FAC084-Part I: Lifting 10- FAC084-Part I: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs 20 Lbs Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Lifting 10-20 Lbs
4.5-9kg, like a large bag of groceries).
C147658 FAC084-Part I: Lifting 10- FAC084-Part I: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs Why Not 20 Lbs Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Lifting 10-20 Lbs Why Not
4.5-9kg, like a large bag of groceries). Please indicate
C147655 FAC084-Part I: Making a FAC084-Part I: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Bed Bed Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Making a Bed
activities?: Making a bed.
C147656 FAC084-Part I: Making a FAC084-Part I: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Bed Why Not Bed Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Making a Bed Why Not
activities?: Making a bed. Please indicate why you did not
do this in the past 7 days.
C147649 FAC084-Part I: Preparing FAC084-Part I: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Meals Meals Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Preparing Meals
activities?: Preparing Meals.
C147650 FAC084-Part I: Preparing FAC084-Part I: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Meals Why Not Meals Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Preparing Meals Why Not
activities?: Preparing Meals. Please indicate why you did
C147653 FAC084-Part I: FAC084-Part I: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Sweeping/Mopping Sweeping/Mopping Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Sweeping/Mopping
activities?: Sweeping or mopping.
C147654 FAC084-Part I: FAC084-Part I: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Sweeping/Mopping Why Sweeping/Mopping Why Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
Not Not days, how short of breath did you get with each of these Sweeping/Mopping Why
activities?: Sweeping or mopping. Please indicate why Not
C147645 FAC084-Part I: Walk 50 FAC084-Part I: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Steps Steps Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these 50 Steps
normal speed without stopping.
page 587 of 1925

C147541 FAC084TN
Code Value
C147646 FAC084-Part I: Walk 50 FAC084-Part I: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Steps Why Not Steps Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these 50 Steps Why Not
normal speed without stopping. Please indicate why you
did not do this in the past 7 days.
C147661 FAC084-Part I: Walk for FAC084-Part I: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
1/2 Mile 1/2 Mile Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these for 1/2 Mile
mile (almost 1 km) without stopping.
C147662 FAC084-Part I: Walk for FAC084-Part I: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
1/2 Mile Why Not 1/2 Mile Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these for 1/2 Mile Why Not
mile (almost 1 km) without stopping. Please indicate why
C147647 FAC084-Part I: Walk Up FAC084-Part I: Walk Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Stairs 20 Stairs Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these Up 20 Stairs
stopping.
C147648 FAC084-Part I: Walk Up FAC084-Part I: Walk Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Stairs Why Not 20 Stairs Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I: Walk
days, how short of breath did you get with each of these Up 20 Stairs Why Not
past 7 days.
C147651 FAC084-Part I: Washing FAC084-Part I: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Dishes Dishes Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Washing Dishes
activities?: Washing dishes.
C147652 FAC084-Part I: Washing FAC084-Part I: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Dishes Why Not Dishes Why Not Dyspnea 10 Item Short Form - Part I. Over the past 7 Short Form - Part I:
days, how short of breath did you get with each of these Washing Dishes Why Not
activities?: Washing dishes. Please indicate why you did
C147671 FAC084-Part II: Carry 10- FAC084-Part II: Carry 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Lbs 20 Lbs Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Carry 10-20 Lbs
doing the following activities: Carrying something
weighing 10-20 lbs (about 4.5-9kg, like a large bag of
groceries) from one room to another.
C147663 FAC084-Part II: Dressing FAC084-Part II: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Without Help Without Help Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Dressing Without Help
doing the following activities: Dressing yourself without
help.
C147670 FAC084-Part II: Lifting FAC084-Part II: Lifting Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
10-20 Lbs 10-20 Lbs Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Lifting 10-20 Lbs
doing the following activities: Lifting something weighing
10-20 lbs (about 4.5-9kg, like a large bag of groceries).
C147669 FAC084-Part II: Making a FAC084-Part II: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Bed Bed Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Making a Bed
doing the following activities: Making a bed.
C147666 FAC084-Part II: Preparing FAC084-Part II: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Meals Meals Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Preparing Meals
doing the following activities: Preparing meals.
C147668 FAC084-Part II: FAC084-Part II: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Sweeping/Mopping Sweeping/Mopping Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Sweeping/Mopping
doing the following activities: Sweeping or mopping.
page 588 of 1925

C147541 FAC084TN
Code Value
C147664 FAC084-Part II: Walk 50 FAC084-Part II: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Steps Steps Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Walk 50 Steps
doing the following activities: Walking 50 steps/paces on
flat ground at a normal speed without stopping.
C147672 FAC084-Part II: Walk for FAC084-Part II: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
1/2 Mile 1/2 Mile Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Walk for 1/2 Mile
doing the following activities: Walking (faster than your
usual speed) for 1/2 mile (almost 1 km) without stopping.
C147665 FAC084-Part II: Walk Up FAC084-Part II: Walk Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
20 Stairs 20 Stairs Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Walk Up 20 Stairs
doing the following activities: Walking up 20 stairs (2
flights) without stopping.
C147667 FAC084-Part II: Washing FAC084-Part II: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea 10 Item
Dishes Dishes Dyspnea 10 Item Short Form - Part II Functional Short Form - Part II:
Limitation. Considering your shortness of breath over the Washing Dishes
doing the following activities: Washing dishes.
page 589 of 1925

FAC099TC (Pediatric Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire Test
Code)
C147546 FAC099TC
Code Value
C147686 FAC09901 FAC099-I Feel Tired Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Feel
Therapy-Fatigue - I feel tired. Tired
C147687 FAC09902 FAC099-I Have Energy Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Have
Therapy-Fatigue - I have energy (or strength). Energy
C147688 FAC09903 FAC099-Could Do My Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Could Do
Usual Things at Home Therapy-Fatigue - I could do my usual things at home. My Usual Things at Home
C147689 FAC09904 FAC099-Trouble Starting Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Trouble
Things Therapy-Fatigue - I had trouble starting things because I Starting Things
was too tired.
C147690 FAC09905 FAC099-Trouble Finishing Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Trouble
Things Therapy-Fatigue - I had trouble finishing things because I Finishing Things
was too tired.
C147691 FAC09906 FAC099-I Needed to Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Needed
Sleep During the Day Therapy-Fatigue - I needed to sleep during the day. to Sleep During the Day
C147692 FAC09907 FAC099-Upset by Being Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Upset by
Too Tired Therapy-Fatigue - I got upset by being too tired to do Being Too Tired
things I wanted to do.
C147693 FAC09908 FAC099-Hard for Me to Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Hard for
Play With Friends Therapy-Fatigue - Being tired made it hard for me to play Me to Play With Friends
or go out with my friends as much as I'd like.
C147694 FAC09909 FAC099-Needed Help Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Needed
Doing Usual Things Therapy-Fatigue - I needed help doing my usual things at Help Doing Usual Things
home.
C147695 FAC09910 FAC099-I Feel Weak Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Feel
Therapy-Fatigue - I feel weak. Weak
C147696 FAC09911 FAC099-I Was Too Tired Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Was Too
to Eat Therapy-Fatigue - I was too tired to eat. Tired to Eat
C147697 FAC09912 FAC099-Being Tired Made Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Being
Me Sad Therapy-Fatigue - Being tired made me sad. Tired Made Me Sad
C147698 FAC09913 FAC099-Being Tired Made Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Being
Me Mad Therapy-Fatigue - Being tired made me mad (angry). Tired Made Me Mad
page 590 of 1925

FAC099TN (Pediatric Functional Assessment of Chronic Illness Therapy-Fatigue Questionnaire Test
Name)
C147545 FAC099TN
Code Value
C147698 FAC099-Being Tired Made FAC099-Being Tired Made Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Being
Me Mad Me Mad Therapy-Fatigue - Being tired made me mad (angry). Tired Made Me Mad
C147697 FAC099-Being Tired Made FAC099-Being Tired Made Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Being
Me Sad Me Sad Therapy-Fatigue - Being tired made me sad. Tired Made Me Sad
C147688 FAC099-Could Do My FAC099-Could Do My Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Could Do
Usual Things at Home Usual Things at Home Therapy-Fatigue - I could do my usual things at home. My Usual Things at Home
C147693 FAC099-Hard for Me to FAC099-Hard for Me to Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Hard for
Play With Friends Play With Friends Therapy-Fatigue - Being tired made it hard for me to play Me to Play With Friends
or go out with my friends as much as I'd like.
C147686 FAC099-I Feel Tired FAC099-I Feel Tired Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Feel
Therapy-Fatigue - I feel tired. Tired
C147695 FAC099-I Feel Weak FAC099-I Feel Weak Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Feel
Therapy-Fatigue - I feel weak. Weak
C147687 FAC099-I Have Energy FAC099-I Have Energy Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Have
Therapy-Fatigue - I have energy (or strength). Energy
C147691 FAC099-I Needed to FAC099-I Needed to Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Needed
Sleep During the Day Sleep During the Day Therapy-Fatigue - I needed to sleep during the day. to Sleep During the Day
C147696 FAC099-I Was Too Tired FAC099-I Was Too Tired Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - I Was Too
to Eat to Eat Therapy-Fatigue - I was too tired to eat. Tired to Eat
C147694 FAC099-Needed Help FAC099-Needed Help Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Needed
Doing Usual Things Doing Usual Things Therapy-Fatigue - I needed help doing my usual things at Help Doing Usual Things
home.
C147690 FAC099-Trouble Finishing FAC099-Trouble Finishing Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Trouble
Things Things Therapy-Fatigue - I had trouble finishing things because I Finishing Things
was too tired.
C147689 FAC099-Trouble Starting FAC099-Trouble Starting Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Trouble
Things Things Therapy-Fatigue - I had trouble starting things because I Starting Things
was too tired.
C147692 FAC099-Upset by Being FAC099-Upset by Being Pediatric Functional Assessment of Chronic Illness Peds-FACIT-F - Upset by
Too Tired Too Tired Therapy-Fatigue - I got upset by being too tired to do Being Too Tired
things I wanted to do.
page 591 of 1925

FAC100TC (Functional Assessment of Chronic Illness Therapy-Dyspnea Scale 33 Item Bank
C154451 FAC100TC
Code Value
C155482 FAC10001 FAC100-Sev: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Without Help Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Dressing
each of these activities?: Dressing yourself without help. Without Help
C155483 FAC10002 FAC100-Sev: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Dressing Why
each of these activities?: Dressing yourself without help. Not
Please indicate why you did not do this in the past 7
days.
C155484 FAC10003 FAC100-Sev: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Walk 50 Steps
each of these activities?: Walking 50 steps/paces on flat
ground at a normal speed without stopping.
C155485 FAC10004 FAC100-Sev: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 50 steps/paces on flat Why Not
ground at a normal speed without stopping. Please
indicate why you did not do this in the past 7 days.
C155486 FAC10005 FAC100-Sev: Walk Up 20 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Stairs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Walk Up 20
each of these activities?: Walking up 20 stairs (2 flights) Stairs
without stopping.
C155487 FAC10006 FAC100-Sev: Walk Up 20 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Stairs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking up 20 stairs (2 flights) Stairs Why Not
without stopping. Please indicate why you did not do this
in the past 7 days.
C155488 FAC10007 FAC100-Sev: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Meals Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Preparing Meals
each of these activities?: Preparing meals.
C155489 FAC10008 FAC100-Sev: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Meals Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Preparing meals. Please indicate Why Not
C155490 FAC10009 FAC100-Sev: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dishes Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Washing Dishes
each of these activities?: Washing dishes.
C155491 FAC10010 FAC100-Sev: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dishes Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Washing dishes. Please indicate Why Not
C155492 FAC10011 FAC100-Sev: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Sweeping/Mopping Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity:
each of these activities?: Sweeping or mopping. Sweeping/Mopping
C155493 FAC10012 FAC100-Sev: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Sweeping/Mopping Why Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
Not the past 7 days, how short of breath did you get with Severity:
each of these activities?: Sweeping or mopping. Please Sweeping/Mopping Why
indicate why you did not do this in the past 7 days. Not
C155494 FAC10013 FAC100-Sev: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Bed Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Making a Bed
each of these activities?: Making a bed.
page 592 of 1925

C154451 FAC100TC
Code Value
C155495 FAC10014 FAC100-Sev: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Bed Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Making a bed. Please indicate Why Not
C155496 FAC10015 FAC100-Sev: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
20 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Lifting 10-20
each of these activities?: Lifting something weighing 10- Lbs
20 lbs (about 4.5-9kg, like a large bag of groceries).
C155497 FAC10016 FAC100-Sev: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
20 Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing 10- Lbs Why Not
days.
C155498 FAC10017 FAC100-Sev: Carry 10-20 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Carry 10-20 Lbs
each of these activities?: Carrying something weighing
10-20 lbs (about 4.5-9kg, like a large bag of groceries)
from one room to another.
C155499 FAC10018 FAC100-Sev: Carry 10-20 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing Why Not
from one room to another. Please indicate why you did
C155500 FAC10019 FAC100-Sev: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
1/2 Mile Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Walk for 1/2
each of these activities?: Walking (faster than your usual Mile
speed) for 1/2 mile (almost 1 km) without stopping.
C155501 FAC10020 FAC100-Sev: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
1/2 Mile Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking (faster than your usual Mile Why Not
days.
C155502 FAC10021 FAC100-Sev: Bath Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Without Help Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Bath Without
each of these activities?: Taking a bath without help. Help
C155503 FAC10022 FAC100-Sev: Bath Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Without Help Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Taking a bath without help. Help Why Not
days.
C155504 FAC10023 FAC100-Sev: Taking a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Shower Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Taking a
each of these activities?: Taking a shower. Shower
C155505 FAC10024 FAC100-Sev: Taking a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Shower Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Taking a shower. Please indicate Shower Why Not
C155506 FAC10025 FAC100-Sev: Putting on Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Socks Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Putting on
each of these activities?: Putting on socks or stockings. Socks
C155507 FAC10026 FAC100-Sev: Putting on Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Socks Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Putting on socks or stockings. Socks Why Not
days.
page 593 of 1925

C154451 FAC100TC
Code Value
C155508 FAC10027 FAC100-Sev: Standing 5 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Minutes Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Standing 5
each of these activities?: Standing for at least 5 minutes. Minutes
C155509 FAC10028 FAC100-Sev: Standing 5 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Minutes Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Standing for at least 5 minutes. Minutes Why Not
days.
C155510 FAC10029 FAC100-Sev: Walking 10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Walking 10
each of these activities?: Walking 10 steps/paces on flat Steps
C155511 FAC10030 FAC100-Sev: Walking 10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 10 steps/paces on flat Steps Why Not
C155512 FAC10031 FAC100-Sev: Walking 1/2 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Mile Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Walking 1/2
each of these activities?: Walking 1/2 mile (almost 1 km) Mile
on flat ground at a normal speed without stopping.
C155513 FAC10032 FAC100-Sev: Walking 1/2 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Mile Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 1/2 mile (almost 1 km) Mile Why Not
on flat ground at a normal speed without stopping. Please
C155514 FAC10033 FAC100-Sev: Walking Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
5 Stairs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Walking Up 5
each of these activities?: Walking up 5 stairs without Stairs
stopping.
5 Stairs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking up 5 stairs without Stairs Why Not
past 7 days.
each of these activities?: Walking up 10 stairs (1 flight) Stairs
without stopping.
each of these activities?: Walking up 10 stairs (1 flight) Stairs Why Not
in the past 7 days.
without stopping.
in the past 7 days.
C155520 FAC10039 FAC100-Sev: Lift Less Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Than 5 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Lift Less Than 5
each of these activities?: Lifting something weighing less Lbs
than 5 lbs (about 2 kg, like a houseplant).
page 594 of 1925

C154451 FAC100TC
Code Value
C155521 FAC10040 FAC100-Sev: Lift Less Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Than 5 Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing less Lbs Why Not
than 5 lbs (about 2 kg, like a houseplant). Please indicate
C155522 FAC10041 FAC100-Sev: Lifting 5-10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Lifting 5-10 Lbs
each of these activities?: Lifting something weighing 5-10
lbs (about 2-4.5 kg, like a basket of clothes).
C155523 FAC10042 FAC100-Sev: Lifting 5-10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing 5-10 Why Not
lbs (about 2-4.5 kg, like a basket of clothes). Please
C155524 FAC10043 FAC100-Sev: Lift More Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Than 20 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Lift More Than
each of these activities?: Lifting something weighing more 20 Lbs
than 20 lbs (about 9 kg, like a medium-sized suitcase).
C155525 FAC10044 FAC100-Sev: Lift More Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Than 20 Lb Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing more 20 Lbs Why Not
days.
C155526 FAC10045 FAC100-Sev: Carrying Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Less Than 5 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Carrying Less
each of these activities?: Carrying something weighing Than 5 Lbs
less than 5 lbs (about 2 kg, like a houseplant) from one
room to another.
C155527 FAC10046 FAC100-Sev: Carrying Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Less Than 5 Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing Than 5 Why Not
room to another. Please indicate why you did not do this
in the past 7 days.
C155528 FAC10047 FAC100-Sev: Carrying 5- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
10 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Carrying 5-10
each of these activities?: Carrying something weighing 5- Lbs
10 lbs (about 2-4.5 kg, like a basket of clothes) from one
room to another.
C155529 FAC10048 FAC100-Sev: Carrying 5- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
10 Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing 5- Lbs Why Not
in the past 7 days.
C155530 FAC10049 FAC100-Sev: Get In/Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
of a Car Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Get In/Out of a
each of these activities?: Getting in or out of a car. Car
C155531 FAC10050 FAC100-Sev: Get In/Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
of a Car Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Getting in or out of a car. Please Car Why Not
C155532 FAC10051 FAC100-Sev: Dining Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Dining Out
each of these activities?: Dining out.
C155533 FAC10052 FAC100-Sev: Dining Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Dining Out Why
each of these activities?: Dining out. Please indicate why Not
page 595 of 1925

C154451 FAC100TC
Code Value
C155534 FAC10053 FAC100-Sev: Low- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
intensity Activ Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Low-intensity
each of these activities?: Low-intensity leisure activity Activity
(gardening, etc.).
C155535 FAC10054 FAC100-Sev: Low- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
intensity Activ Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Low-intensity leisure activity Activity Why Not
(gardening, etc.). Please indicate why you did not do this
in the past 7 days.
C155536 FAC10055 FAC100-Sev: Moderate Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Activity Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Moderate
each of these activities?: Moderate-intensity leisure Activity
activity (bicycling on level terrain, etc.).
C155537 FAC10056 FAC100-Sev: Moderate Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Activity Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Moderate-intensity leisure Activity Why Not
activity (bicycling on level terrain, etc.). Please indicate
C155538 FAC10057 FAC100-Sev: Walk Fast Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
50 Steps Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Walk Fast 50
each of these activities?: Walking (faster than your usual Steps
speed) for 50 steps without stopping.
C155539 FAC10058 FAC100-Sev: Walk Fast Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
50 Steps Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking (faster than your usual Steps Why Not
speed) for 50 steps without stopping. Please indicate why
C155540 FAC10059 FAC100-Sev: Walking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Fast 1 Mile Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Walking Fast 1
speed) for at least 1 mile ( a little more than 1.5 km)
without stopping.
C155541 FAC10060 FAC100-Sev: Walking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Fast 1 Mile Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
in the past 7 days.
C155542 FAC10061 FAC100-Sev: Singing or Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Humming Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Singing or
each of these activities?: Singing or humming. Humming
C155543 FAC10062 FAC100-Sev: Singing or Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Humming Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Singing or humming. Please Humming Why Not
C155544 FAC10063 FAC100-Sev: Talking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
While Walking Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Talking While
each of these activities?: Talking while walking. Walking
C155545 FAC10064 FAC100-Sev: Talking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
While Walk Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Talking while walking. Please Walk Why Not
C155546 FAC10065 FAC100-Sev: Scrubbing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
the Floor Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Scrubbing the
each of these activities?: Scrubbing the floor or counter. Floor
page 596 of 1925

C154451 FAC100TC
Code Value
C155547 FAC10066 FAC100-Sev: Scrubbing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
the Floor Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Scrubbing the floor or counter. Floor Why Not
days.
C155548 FAC10067 FAC100-Limit: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Without Help Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Dressing Without
days, rate the amount of difficulty you had when doing Help
the following activities: Dressing yourself without help.
C155549 FAC10068 FAC100-Limit: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walk 50 Steps
days, rate the amount of difficulty you had when doing
the following activities: Walking 50 steps/paces on flat
C155550 FAC10069 FAC100-Limit: Walk Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
20 Stairs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walk Up 20 Stairs
the following activities: Walking up 20 stairs (2 flights)
without stopping.
C155551 FAC10070 FAC100-Limit: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Meals Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Preparing Meals
the following activities: Preparing meals.
C155552 FAC10071 FAC100-Limit: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dishes Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Washing Dishes
the following activities: Washing dishes.
C155553 FAC10072 FAC100-Limit: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Sweeping/Mopping Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Sweeping/Mopping
the following activities: Sweeping or mopping.
C155554 FAC10073 FAC100-Limit: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Bed Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Making a Bed
the following activities: Making a bed.
C155555 FAC10074 FAC100-Limit: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
20 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Lifting 10-20 Lbs
the following activities: Lifting something weighing 10-20
lbs (about 4.5-9kg, like a large bag of groceries).
C155556 FAC10075 FAC100-Limit: Carry 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Considering your shortness of breath over the past 7 Limit: Carry 10-20 Lbs
the following activities: Carrying something weighing 10-
20 lbs (about 4.5-9kg, like a large bag of groceries) from
one room to another.
C155557 FAC10076 FAC100-Limit: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
1/2 Mile Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walk for 1/2 Mile
the following activities: Walking (faster than your usual
C155558 FAC10077 FAC100-Limit: Taking a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Bath Without Help Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Taking a Bath
days, rate the amount of difficulty you had when doing Without Help
the following activities: Taking a bath without help.
C155559 FAC10078 FAC100-Limit: Taking a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Shower Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Taking a Shower
the following activities: Taking a shower.
page 597 of 1925

C154451 FAC100TC
Code Value
C155560 FAC10079 FAC100-Limit: Putting on Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Socks Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Putting on Socks
the following activities: Putting on socks or stockings.
C155561 FAC10080 FAC100-Limit: Standing 5 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Minutes Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Standing 5 Minutes
the following activities: Standing for at least 5 minutes.
C155562 FAC10081 FAC100-Limit: Walking 10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walking 10 Steps
C155563 FAC10082 FAC100-Limit: Walking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
1/2 Mile Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walking 1/2 Mile
the following activities: Walking 1/2 mile (almost 1 km)
Up 5 Stairs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walking Up 5
days, rate the amount of difficulty you had when doing Stairs
the following activities: Walking up 5 stairs without
stopping.
the following activities: Walking up 10 stairs (1 flight)
without stopping.
without stopping.
C155567 FAC10086 FAC100-Limit: Scrubbing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
the Floor Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Scrubbing the Floor
the following activities: Scrubbing the floor or counter.
C155568 FAC10087 FAC100-Limit: Lifting Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Less Than 5 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Lifting Less Than 5
days, rate the amount of difficulty you had when doing Lbs
the following activities: Lifting something weighing less
C155569 FAC10088 FAC100-Limit: Lifting 5- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
C155570 FAC10089 FAC100-Limit: Lifting Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
More Than 20 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Lifting More Than
days, rate the amount of difficulty you had when doing 20 Lbs
the following activities: Lifting something weighing more
C155571 FAC10090 FAC100-Limit: Carrying Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Less Than 5 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Carrying Less Than
the following activities: Carrying something weighing less
than 5 lbs (about 2 kg, like a houseplant) from one room
to another.
page 598 of 1925

C154451 FAC100TC
Code Value
C155572 FAC10091 FAC100-Limit: Carrying Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
5-10 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Carrying 5-10 Lbs
room to another.
C155573 FAC10092 FAC100-Limit: Get In/Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
of a Car Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Get In/Out of a Car
the following activities: Getting in or out of a car.
C155574 FAC10093 FAC100-Limit: Dining Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Dining Out
the following activities: Dining out.
C155575 FAC10094 FAC100-Limit: Low- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
intensity Activity Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Low-intensity
days, rate the amount of difficulty you had when doing Activity
the following activities: Low-intensity leisure activity
(gardening, etc.).
C155576 FAC10095 FAC100-Limit: Moderate Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Activity Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Moderate Activity
the following activities: Moderate-intensity leisure activity
(bicycling on level terrain, etc.).
C155577 FAC10096 FAC100-Limit: Walk Fast Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
50 Steps Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walk Fast 50 Steps
Fast 1 Mile Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walking Fast 1 Mile
speed) for at least 1 mile (a little more than 1.5 km)
without stopping.
C155579 FAC10098 FAC100-Limit: Singing or Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Humming Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Singing or
days, rate the amount of difficulty you had when doing Humming
the following activities: Singing or humming.
C155580 FAC10099 FAC100-Limit: Talking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
While Walking Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Talking While
days, rate the amount of difficulty you had when doing Walking
the following activities: Talking while walking.
page 599 of 1925

FAC100TN (Functional Assessment of Chronic Illness Therapy-Dyspnea Scale 33 Item Bank
C154450 FAC100TN
Code Value
C155556 FAC100-Limit: Carry 10- FAC100-Limit: Carry 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
20 Lbs 20 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Carry 10-20 Lbs
20 lbs (about 4.5-9kg, like a large bag of groceries) from
one room to another.
C155572 FAC100-Limit: Carrying FAC100-Limit: Carrying Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
5-10 Lbs 5-10 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Carrying 5-10 Lbs
room to another.
C155571 FAC100-Limit: Carrying FAC100-Limit: Carrying Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Less Than 5 Lbs Less Than 5 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Carrying Less Than
the following activities: Carrying something weighing less
than 5 lbs (about 2 kg, like a houseplant) from one room
to another.
C155574 FAC100-Limit: Dining Out FAC100-Limit: Dining Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Dining Out
the following activities: Dining out.
C155548 FAC100-Limit: Dressing FAC100-Limit: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Without Help Without Help Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Dressing Without
days, rate the amount of difficulty you had when doing Help
the following activities: Dressing yourself without help.
C155573 FAC100-Limit: Get In/Out FAC100-Limit: Get In/Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
of a Car of a Car Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Get In/Out of a Car
the following activities: Getting in or out of a car.
C155555 FAC100-Limit: Lifting 10- FAC100-Limit: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
lbs (about 4.5-9kg, like a large bag of groceries).
C155569 FAC100-Limit: Lifting 5- FAC100-Limit: Lifting 5- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
C155568 FAC100-Limit: Lifting FAC100-Limit: Lifting Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Less Than 5 Lbs Less Than 5 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Lifting Less Than 5
days, rate the amount of difficulty you had when doing Lbs
the following activities: Lifting something weighing less
C155570 FAC100-Limit: Lifting FAC100-Limit: Lifting Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
More Than 20 Lbs More Than 20 Lbs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Lifting More Than
the following activities: Lifting something weighing more
C155575 FAC100-Limit: Low- FAC100-Limit: Low- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
intensity Activity intensity Activity Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Low-intensity
days, rate the amount of difficulty you had when doing Activity
the following activities: Low-intensity leisure activity
(gardening, etc.).
page 600 of 1925

C154450 FAC100TN
Code Value
C155554 FAC100-Limit: Making a FAC100-Limit: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Bed Bed Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Making a Bed
the following activities: Making a bed.
C155576 FAC100-Limit: Moderate FAC100-Limit: Moderate Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Activity Activity Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Moderate Activity
the following activities: Moderate-intensity leisure activity
(bicycling on level terrain, etc.).
C155551 FAC100-Limit: Preparing FAC100-Limit: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Meals Meals Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Preparing Meals
the following activities: Preparing meals.
C155560 FAC100-Limit: Putting on FAC100-Limit: Putting on Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Socks Socks Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Putting on Socks
the following activities: Putting on socks or stockings.
C155567 FAC100-Limit: Scrubbing FAC100-Limit: Scrubbing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
the Floor the Floor Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Scrubbing the Floor
the following activities: Scrubbing the floor or counter.
C155579 FAC100-Limit: Singing or FAC100-Limit: Singing or Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Humming Humming Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Singing or
days, rate the amount of difficulty you had when doing Humming
the following activities: Singing or humming.
C155561 FAC100-Limit: Standing 5 FAC100-Limit: Standing 5 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Minutes Minutes Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Standing 5 Minutes
the following activities: Standing for at least 5 minutes.
C155553 FAC100-Limit: FAC100-Limit: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Sweeping/Mopping Sweeping/Mopping Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Sweeping/Mopping
the following activities: Sweeping or mopping.
C155558 FAC100-Limit: Taking a FAC100-Limit: Taking a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Bath Without Help Bath Without Help Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Taking a Bath
days, rate the amount of difficulty you had when doing Without Help
the following activities: Taking a bath without help.
C155559 FAC100-Limit: Taking a FAC100-Limit: Taking a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Shower Shower Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Taking a Shower
the following activities: Taking a shower.
C155580 FAC100-Limit: Talking FAC100-Limit: Talking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
While Walking While Walking Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Talking While
days, rate the amount of difficulty you had when doing Walking
the following activities: Talking while walking.
C155549 FAC100-Limit: Walk 50 FAC100-Limit: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Steps Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walk 50 Steps
C155577 FAC100-Limit: Walk Fast FAC100-Limit: Walk Fast Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
50 Steps 50 Steps Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walk Fast 50 Steps
page 601 of 1925

C154450 FAC100TN
Code Value
C155557 FAC100-Limit: Walk for FAC100-Limit: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
1/2 Mile 1/2 Mile Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walk for 1/2 Mile
C155550 FAC100-Limit: Walk Up FAC100-Limit: Walk Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
20 Stairs 20 Stairs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walk Up 20 Stairs
without stopping.
C155563 FAC100-Limit: Walking FAC100-Limit: Walking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
1/2 Mile 1/2 Mile Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walking 1/2 Mile
the following activities: Walking 1/2 mile (almost 1 km)
C155562 FAC100-Limit: Walking 10 FAC100-Limit: Walking 10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Steps Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walking 10 Steps
Fast 1 Mile Fast 1 Mile Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Walking Fast 1 Mile
speed) for at least 1 mile (a little more than 1.5 km)
without stopping.
Up 10 Stairs Up 10 Stairs Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
the following activities: Walking up 10 stairs (1 flight)
without stopping.
without stopping.
the following activities: Walking up 5 stairs without
stopping.
C155552 FAC100-Limit: Washing FAC100-Limit: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dishes Dishes Dyspnea Scale 33 Item Bank - Functional Limitation: Item Bank Version -
Considering your shortness of breath over the past 7 Limit: Washing Dishes
the following activities: Washing dishes.
C155502 FAC100-Sev: Bath FAC100-Sev: Bath Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Without Help Without Help Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Taking a bath without help. Help
C155503 FAC100-Sev: Bath FAC100-Sev: Bath Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Without Help Why Not Without Help Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Taking a bath without help. Help Why Not
days.
C155498 FAC100-Sev: Carry 10-20 FAC100-Sev: Carry 10-20 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Lbs Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing
from one room to another.
page 602 of 1925

C154450 FAC100TN
Code Value
C155499 FAC100-Sev: Carry 10-20 FAC100-Sev: Carry 10-20 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Lbs Why Not Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing Why Not
from one room to another. Please indicate why you did
C155528 FAC100-Sev: Carrying 5- FAC100-Sev: Carrying 5- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
10 Lbs 10 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing 5- Lbs
room to another.
C155529 FAC100-Sev: Carrying 5- FAC100-Sev: Carrying 5- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
10 Lbs Why Not 10 Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing 5- Lbs Why Not
in the past 7 days.
C155526 FAC100-Sev: Carrying FAC100-Sev: Carrying Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Less Than 5 Lbs Less Than 5 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing Than 5 Lbs
room to another.
C155527 FAC100-Sev: Carrying FAC100-Sev: Carrying Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Less Than 5 Why Not Less Than 5 Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Carrying something weighing Than 5 Why Not
in the past 7 days.
C155532 FAC100-Sev: Dining Out FAC100-Sev: Dining Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Dining Out
each of these activities?: Dining out.
C155533 FAC100-Sev: Dining Out FAC100-Sev: Dining Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Why Not Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Dining Out Why
each of these activities?: Dining out. Please indicate why Not
C155483 FAC100-Sev: Dressing FAC100-Sev: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Why Not Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Dressing Why
each of these activities?: Dressing yourself without help. Not
days.
C155482 FAC100-Sev: Dressing FAC100-Sev: Dressing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Without Help Without Help Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity: Dressing
each of these activities?: Dressing yourself without help. Without Help
C155530 FAC100-Sev: Get In/Out FAC100-Sev: Get In/Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
of a Car of a Car Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Getting in or out of a car. Car
C155531 FAC100-Sev: Get In/Out FAC100-Sev: Get In/Out Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
of a Car Why Not of a Car Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Getting in or out of a car. Please Car Why Not
C155520 FAC100-Sev: Lift Less FAC100-Sev: Lift Less Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Than 5 Lbs Than 5 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing less Lbs
C155521 FAC100-Sev: Lift Less FAC100-Sev: Lift Less Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Than 5 Lbs Why Not Than 5 Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing less Lbs Why Not
than 5 lbs (about 2 kg, like a houseplant). Please indicate
page 603 of 1925

C154450 FAC100TN
Code Value
C155525 FAC100-Sev: Lift More FAC100-Sev: Lift More Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Than 20 Lb Why Not Than 20 Lb Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing more 20 Lbs Why Not
days.
C155524 FAC100-Sev: Lift More FAC100-Sev: Lift More Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Than 20 Lbs Than 20 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing more 20 Lbs
C155496 FAC100-Sev: Lifting 10- FAC100-Sev: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
20 Lbs 20 Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing 10- Lbs
C155497 FAC100-Sev: Lifting 10- FAC100-Sev: Lifting 10- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
20 Lbs Why Not 20 Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing 10- Lbs Why Not
days.
C155522 FAC100-Sev: Lifting 5-10 FAC100-Sev: Lifting 5-10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Lbs Lbs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing 5-10
C155523 FAC100-Sev: Lifting 5-10 FAC100-Sev: Lifting 5-10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Lbs Why Not Lbs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Lifting something weighing 5-10 Why Not
lbs (about 2-4.5 kg, like a basket of clothes). Please
C155534 FAC100-Sev: Low- FAC100-Sev: Low- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
intensity Activ intensity Activ Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Low-intensity leisure activity Activity
(gardening, etc.).
C155535 FAC100-Sev: Low- FAC100-Sev: Low- Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
intensity Activ Why Not intensity Activ Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Low-intensity leisure activity Activity Why Not
(gardening, etc.). Please indicate why you did not do this
in the past 7 days.
C155494 FAC100-Sev: Making a FAC100-Sev: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Bed Bed Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Making a bed.
C155495 FAC100-Sev: Making a FAC100-Sev: Making a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Bed Why Not Bed Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Making a bed. Please indicate Why Not
C155536 FAC100-Sev: Moderate FAC100-Sev: Moderate Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Activity Activity Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Moderate-intensity leisure Activity
activity (bicycling on level terrain, etc.).
C155537 FAC100-Sev: Moderate FAC100-Sev: Moderate Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Activity Why Not Activity Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Moderate-intensity leisure Activity Why Not
activity (bicycling on level terrain, etc.). Please indicate
C155488 FAC100-Sev: Preparing FAC100-Sev: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Meals Meals Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Preparing meals.
page 604 of 1925

C154450 FAC100TN
Code Value
C155489 FAC100-Sev: Preparing FAC100-Sev: Preparing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Meals Why Not Meals Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Preparing meals. Please indicate Why Not
C155506 FAC100-Sev: Putting on FAC100-Sev: Putting on Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Socks Socks Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Putting on socks or stockings. Socks
C155507 FAC100-Sev: Putting on FAC100-Sev: Putting on Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Socks Why Not Socks Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Putting on socks or stockings. Socks Why Not
days.
C155546 FAC100-Sev: Scrubbing FAC100-Sev: Scrubbing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
the Floor the Floor Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Scrubbing the floor or counter. Floor
C155547 FAC100-Sev: Scrubbing FAC100-Sev: Scrubbing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
the Floor Why Not the Floor Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Scrubbing the floor or counter. Floor Why Not
days.
C155542 FAC100-Sev: Singing or FAC100-Sev: Singing or Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Humming Humming Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Singing or humming. Humming
C155543 FAC100-Sev: Singing or FAC100-Sev: Singing or Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Humming Why Not Humming Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Singing or humming. Please Humming Why Not
C155508 FAC100-Sev: Standing 5 FAC100-Sev: Standing 5 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Minutes Minutes Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Standing for at least 5 minutes. Minutes
C155509 FAC100-Sev: Standing 5 FAC100-Sev: Standing 5 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Minutes Why Not Minutes Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Standing for at least 5 minutes. Minutes Why Not
days.
C155492 FAC100-Sev: FAC100-Sev: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Sweeping/Mopping Sweeping/Mopping Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
the past 7 days, how short of breath did you get with Severity:
each of these activities?: Sweeping or mopping. Sweeping/Mopping
C155493 FAC100-Sev: FAC100-Sev: Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Sweeping/Mopping Why Sweeping/Mopping Why Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
Not Not the past 7 days, how short of breath did you get with Severity:
each of these activities?: Sweeping or mopping. Please Sweeping/Mopping Why
indicate why you did not do this in the past 7 days. Not
C155504 FAC100-Sev: Taking a FAC100-Sev: Taking a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Shower Shower Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Taking a shower. Shower
C155505 FAC100-Sev: Taking a FAC100-Sev: Taking a Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Shower Why Not Shower Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Taking a shower. Please indicate Shower Why Not
C155545 FAC100-Sev: Talking FAC100-Sev: Talking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
While Walk Why Not While Walk Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Talking while walking. Please Walk Why Not
C155544 FAC100-Sev: Talking FAC100-Sev: Talking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
While Walking While Walking Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Talking while walking. Walking
page 605 of 1925

C154450 FAC100TN
Code Value
C155484 FAC100-Sev: Walk 50 FAC100-Sev: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Steps Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 50 steps/paces on flat
C155485 FAC100-Sev: Walk 50 FAC100-Sev: Walk 50 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Why Not Steps Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 50 steps/paces on flat Why Not
C155538 FAC100-Sev: Walk Fast FAC100-Sev: Walk Fast Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
50 Steps 50 Steps Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking (faster than your usual Steps
C155539 FAC100-Sev: Walk Fast FAC100-Sev: Walk Fast Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
50 Steps Why Not 50 Steps Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking (faster than your usual Steps Why Not
speed) for 50 steps without stopping. Please indicate why
C155500 FAC100-Sev: Walk for FAC100-Sev: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
1/2 Mile 1/2 Mile Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
C155501 FAC100-Sev: Walk for FAC100-Sev: Walk for Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
1/2 Mile Why Not 1/2 Mile Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
days.
C155486 FAC100-Sev: Walk Up 20 FAC100-Sev: Walk Up 20 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Stairs Stairs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
without stopping.
C155487 FAC100-Sev: Walk Up 20 FAC100-Sev: Walk Up 20 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Stairs Why Not Stairs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
in the past 7 days.
C155512 FAC100-Sev: Walking 1/2 FAC100-Sev: Walking 1/2 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Mile Mile Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 1/2 mile (almost 1 km) Mile
C155513 FAC100-Sev: Walking 1/2 FAC100-Sev: Walking 1/2 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Mile Why Not Mile Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 1/2 mile (almost 1 km) Mile Why Not
on flat ground at a normal speed without stopping. Please
C155510 FAC100-Sev: Walking 10 FAC100-Sev: Walking 10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Steps Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 10 steps/paces on flat Steps
C155511 FAC100-Sev: Walking 10 FAC100-Sev: Walking 10 Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Steps Why Not Steps Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking 10 steps/paces on flat Steps Why Not
C155540 FAC100-Sev: Walking FAC100-Sev: Walking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Fast 1 Mile Fast 1 Mile Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
without stopping.
page 606 of 1925

C154450 FAC100TN
Code Value
C155541 FAC100-Sev: Walking FAC100-Sev: Walking Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Fast 1 Mile Why Not Fast 1 Mile Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
in the past 7 days.
C155516 FAC100-Sev: Walking Up FAC100-Sev: Walking Up Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
10 Stairs 10 Stairs Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking up 10 stairs (1 flight) Stairs
without stopping.
10 Stairs Why Not 10 Stairs Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Walking up 10 stairs (1 flight) Stairs Why Not
in the past 7 days.
without stopping.
in the past 7 days.
each of these activities?: Walking up 5 stairs without Stairs
stopping.
each of these activities?: Walking up 5 stairs without Stairs Why Not
past 7 days.
C155490 FAC100-Sev: Washing FAC100-Sev: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dishes Dishes Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Washing dishes.
C155491 FAC100-Sev: Washing FAC100-Sev: Washing Functional Assessment of Chronic Illness Therapy- FACIT-Dyspnea Scale 33
Dishes Why Not Dishes Why Not Dyspnea Scale 33 Item Bank - Dyspnea Severity: Over Item Bank Version -
each of these activities?: Washing dishes. Please indicate Why Not
page 607 of 1925

FAMS01TC (Functional Assessment of Multiple Sclerosis Version 4 Questionnaire Test Code)
C112441 FAMS01TC
Code Value
C112551 FAMS0101 FAMS01-Trouble Meeting Functional Assessment of Multiple Sclerosis - Mobility: FAMS - Have Trouble
Needs of Family Because of my physical condition, I have trouble meeting Meeting Needs of Family
the needs of my family. Because of My Condition
C112552 FAMS0102 FAMS01-I Am Able to Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - I Am Able to
Work am able to work (include work at home). Work
C112553 FAMS0103 FAMS01-I Have Trouble Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - I Have Trouble
Walking have trouble walking. Walking
C112554 FAMS0104 FAMS01-Limit My Social Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - Limit Social
Activity have to limit my social activity because of my condition. Activity Because of
Condition
C112555 FAMS0105 FAMS01-I Have Strength Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - I Have Strength
in My Legs have strength in my legs. in My Legs
C112556 FAMS0106 FAMS01-Trouble Getting Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - Trouble Getting
Around in Public have trouble getting around in public places. Around in Public Places
C112557 FAMS0107 FAMS01-Take My Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - Have to Take
Condition Into Account have to take my condition into account when making Condition Into Account
plans. When Making Plans
C112558 FAMS0108 FAMS01-I Have Nausea Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Have Nausea
I have nausea.
C112559 FAMS0109 FAMS01-I Have Pain Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Have Pain
I have pain.
C112560 FAMS0110 FAMS01-I Feel Ill Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Feel Ill
I feel ill.
C112561 FAMS0111 FAMS01-I Feel Weak All Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Feel Weak All
Over I feel weak all over. Over
C112562 FAMS0112 FAMS01-I Have Pain in Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Have Pain in My
My Joints I have pain in my joints. Joints
C112563 FAMS0113 FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - Bothered by
by Headaches I am bothered by headaches. Headaches
C112564 FAMS0114 FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - Bothered by
by Muscle Pains I am bothered by muscle pains. Muscle Pains
C112565 FAMS0115 FAMS01-I Feel Sad Functional Assessment of Multiple Sclerosis - Emotional FAMS - I Feel Sad
Well-Being: I feel sad.
C112566 FAMS0116 FAMS01-Losing Hope Functional Assessment of Multiple Sclerosis - Emotional FAMS - Losing Hope in
Against Illness Well-Being: I am losing hope in the fight against my Fight Against My Illness
illness.
C112567 FAMS0117 FAMS01-I Am Able to Functional Assessment of Multiple Sclerosis - Emotional FAMS - I Am Able to
Enjoy Life Well-Being: I am able to enjoy life. Enjoy Life
C112568 FAMS0118 FAMS01-I Feel Trapped Functional Assessment of Multiple Sclerosis - Emotional FAMS - Feel Trapped by
by My Condition Well-Being: I feel trapped by my condition. My Condition
C112569 FAMS0119 FAMS01-I Am Depressed Functional Assessment of Multiple Sclerosis - Emotional FAMS - Depressed About
About My Condition Well-Being: I am depressed about my condition. My Condition
C112570 FAMS0120 FAMS01-I Feel Useless Functional Assessment of Multiple Sclerosis - Emotional FAMS - I Feel Useless
Well-Being: I feel useless.
C112571 FAMS0121 FAMS01-Feel Functional Assessment of Multiple Sclerosis - Emotional FAMS - Feel
Overwhelmed by My Well-Being: I feel overwhelmed by my condition. Overwhelmed by My
Condition Condition
C112572 FAMS0122 FAMS01-My Work Is Functional Assessment of Multiple Sclerosis - General FAMS - My Work is
Fulfilling Contentment: My work (include work at home) is Fulfilling
fulfilling.
C112573 FAMS0123 FAMS01-I Have Accepted Functional Assessment of Multiple Sclerosis - General FAMS - I Have Accepted
My Illness Contentment: I have accepted my illness. My Illness
C112574 FAMS0124 FAMS01-Enjoy Things I Functional Assessment of Multiple Sclerosis - General FAMS - Enjoying Things I
Usually Do for Fun Contentment: I am enjoying the things I usually do for Usually Do for Fun
fun.
page 608 of 1925

C112441 FAMS01TC
Code Value
C112575 FAMS0125 FAMS01-Content With Functional Assessment of Multiple Sclerosis - General FAMS - Content With
Quality of My Life Contentment: I am content with the quality of my life Quality of My Life Now
right now.
C112576 FAMS0126 FAMS01-I Am Frustrated Functional Assessment of Multiple Sclerosis - General FAMS - I Am Frustrated
by My Condition Contentment: I am frustrated by my condition. by My Condition
C112577 FAMS0127 FAMS01-Feel Sense of Functional Assessment of Multiple Sclerosis - General FAMS - Feel Sense of
Purpose in My Life Contentment: I feel a sense of purpose in my life. Purpose in My Life
C112578 FAMS0128 FAMS01-I Feel Motivated Functional Assessment of Multiple Sclerosis - General FAMS - Feel Motivated to
to Do Things Contentment: I feel motivated to do things. Do Things
C112579 FAMS0129 FAMS01-I Have a Lack of Functional Assessment of Multiple Sclerosis - Thinking FAMS - Have a Lack of
Energy and Fatigue: I have a lack of energy. Energy
C112580 FAMS0130 FAMS01-I Feel Tired Functional Assessment of Multiple Sclerosis - Thinking FAMS - I Feel Tired
and Fatigue: I feel tired.
C112581 FAMS0131 FAMS01-Trouble Starting Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble Starting
Things and Fatigue: I have trouble starting things because I am Things Because I Am
tired. Tired
C112582 FAMS0132 FAMS01-Trouble Finishing Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble Finishing
Things and Fatigue: I have trouble finishing things because I am Things Because I Am
tired. Tired
C112583 FAMS0133 FAMS01-I Need to Rest Functional Assessment of Multiple Sclerosis - Thinking FAMS - Need to Rest
During the Day and Fatigue: I need to rest during the day. During the Day
C112584 FAMS0134 FAMS01-I Have Trouble Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble
Remembering Things and Fatigue: I have trouble remembering things. Remembering Things
C112585 FAMS0135 FAMS01-I Have Trouble Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble
Concentrating and Fatigue: I have trouble concentrating. Concentrating
C112586 FAMS0136 FAMS01-My Thinking Is Functional Assessment of Multiple Sclerosis - Thinking FAMS - My Thinking is
Slower Than Before and Fatigue: My thinking is slower than before. Slower Than Before
C112587 FAMS0137 FAMS01-I Have Trouble Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble Learning
Learning New Tasks and Fatigue: I have trouble learning new tasks or New Tasks or Directions
directions.
C112588 FAMS0138 FAMS01-I Feel Close to Functional Assessment of Multiple Sclerosis - FAMS - Feel Close to My
My Friends Family/Social Well-Being: I feel close to my friends. Friends
C112589 FAMS0139 FAMS01-Get Emotional Functional Assessment of Multiple Sclerosis - FAMS - Get Emotional
Support From Family Family/Social Well-Being: I get emotional support from Support From Family
my family.
C112590 FAMS0140 FAMS01-I Get Support Functional Assessment of Multiple Sclerosis - FAMS - Get Support From
From My Friends Family/Social Well-Being: I get support from my friends. Friends
C112591 FAMS0141 FAMS01-My Family Has Functional Assessment of Multiple Sclerosis - FAMS - Family Has
Accepted My Illness Family/Social Well-Being: My family has accepted my Accepted My Illness
illness.
C112592 FAMS0142 FAMS01-Satisfied Functional Assessment of Multiple Sclerosis - FAMS - Satisfied With
Communication Illness Family/Social Well-Being: I am satisfied with family Family Communication
communication about my illness. About My Illness
C112593 FAMS0143 FAMS01-Trouble Functional Assessment of Multiple Sclerosis - FAMS - Family Has
Understanding Worsening Family/Social Well-Being: My family has trouble Trouble Understanding
understanding when my condition gets worse. When My Condition Gets
Worse
C112594 FAMS0144 FAMS01-I Feel Left Out of Functional Assessment of Multiple Sclerosis - FAMS - Feel Left Out of
Things Family/Social Well-Being: I feel 'left out' of things. Things
C112595 FAMS0145 FAMS01-Bothered by Functional Assessment of Multiple Sclerosis - Additional FAMS - Bothered by Side
Treatment Side Effect Concerns: I am bothered by side effects of treatment. Effects of Treatment
C112596 FAMS0146 FAMS01-I Am Forced to Functional Assessment of Multiple Sclerosis - Additional FAMS - Forced to Spend
Spend Time in Bed Concerns: I am forced to spend time in bed. Time in Bed
C112597 FAMS0147 FAMS01-I Feel Close to Functional Assessment of Multiple Sclerosis - Additional FAMS - Feel Close to My
My Partner Concerns: I feel close to my partner (or the person who is Partner
my main support).
C112598 FAMS0148 FAMS01-I Am Satisfied Functional Assessment of Multiple Sclerosis - Additional FAMS - Satisfied With My
With My Sex Life Concerns: I am satisfied with my sex life. Sex Life
page 609 of 1925

C112441 FAMS01TC
Code Value
C112599 FAMS0149 FAMS01-Satisfied With Functional Assessment of Multiple Sclerosis - Additional FAMS - Satisfied With
How I Am Coping Concerns: I am satisfied with how I am coping with my How I Am Coping With
illness. Illness
C112600 FAMS0150 FAMS01-I Feel Nervous Functional Assessment of Multiple Sclerosis - Additional FAMS - I Feel Nervous
Concerns: I feel nervous.
C112601 FAMS0151 FAMS01-Worry My Functional Assessment of Multiple Sclerosis - Additional FAMS - Worry My
Condition Will Get Worse Concerns: I worry that my condition will get worse. Condition Will Get Worse
C112602 FAMS0152 FAMS01-I Am Sleeping Functional Assessment of Multiple Sclerosis - Additional FAMS - I Am Sleeping
Well Concerns: I am sleeping well. Well
C112603 FAMS0153 FAMS01-Heat Worsens Functional Assessment of Multiple Sclerosis - Additional FAMS - Heat Worsens My
My Symptoms Concerns: Heat worsens my symptoms. Symptoms
C112604 FAMS0154 FAMS01-Have Trouble Functional Assessment of Multiple Sclerosis - Additional FAMS - Trouble
Controlling My Urine Concerns: I have trouble controlling my urine. Controlling My Urine
C112605 FAMS0155 FAMS01-I Urinate More Functional Assessment of Multiple Sclerosis - Additional FAMS - Urinate More
Frequently Concerns: I urinate more frequently than usual. Frequently Than Usual
C112606 FAMS0156 FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Additional FAMS - Bothered by Chills
by the Chills Concerns: I am bothered by the chills.
C112607 FAMS0157 FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Additional FAMS - Bothered by
by Fevers Concerns: I am bothered by fevers (episodes of high Fevers
body temperature).
C112608 FAMS0158 FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Additional FAMS - Bothered by
by Muscle Spasms Concerns: I am bothered by muscle spasms. Muscle Spasms
page 610 of 1925

FAMS01TN (Functional Assessment of Multiple Sclerosis Version 4 Questionnaire Test Name)
C112440 FAMS01TN
Code Value
C112595 FAMS01-Bothered by FAMS01-Bothered by Functional Assessment of Multiple Sclerosis - Additional FAMS - Bothered by Side
Treatment Side Effect Treatment Side Effect Concerns: I am bothered by side effects of treatment. Effects of Treatment
C112575 FAMS01-Content With FAMS01-Content With Functional Assessment of Multiple Sclerosis - General FAMS - Content With
Quality of My Life Quality of My Life Contentment: I am content with the quality of my life Quality of My Life Now
right now.
C112574 FAMS01-Enjoy Things I FAMS01-Enjoy Things I Functional Assessment of Multiple Sclerosis - General FAMS - Enjoying Things I
Usually Do for Fun Usually Do for Fun Contentment: I am enjoying the things I usually do for Usually Do for Fun
fun.
C112571 FAMS01-Feel FAMS01-Feel Functional Assessment of Multiple Sclerosis - Emotional FAMS - Feel
Overwhelmed by My Overwhelmed by My Well-Being: I feel overwhelmed by my condition. Overwhelmed by My
Condition Condition Condition
C112577 FAMS01-Feel Sense of FAMS01-Feel Sense of Functional Assessment of Multiple Sclerosis - General FAMS - Feel Sense of
Purpose in My Life Purpose in My Life Contentment: I feel a sense of purpose in my life. Purpose in My Life
C112589 FAMS01-Get Emotional FAMS01-Get Emotional Functional Assessment of Multiple Sclerosis - FAMS - Get Emotional
Support From Family Support From Family Family/Social Well-Being: I get emotional support from Support From Family
my family.
C112604 FAMS01-Have Trouble FAMS01-Have Trouble Functional Assessment of Multiple Sclerosis - Additional FAMS - Trouble
Controlling My Urine Controlling My Urine Concerns: I have trouble controlling my urine. Controlling My Urine
C112603 FAMS01-Heat Worsens FAMS01-Heat Worsens Functional Assessment of Multiple Sclerosis - Additional FAMS - Heat Worsens My
My Symptoms My Symptoms Concerns: Heat worsens my symptoms. Symptoms
C112567 FAMS01-I Am Able to FAMS01-I Am Able to Functional Assessment of Multiple Sclerosis - Emotional FAMS - I Am Able to
Enjoy Life Enjoy Life Well-Being: I am able to enjoy life. Enjoy Life
C112552 FAMS01-I Am Able to FAMS01-I Am Able to Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - I Am Able to
Work Work am able to work (include work at home). Work
C112607 FAMS01-I Am Bothered FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Additional FAMS - Bothered by
by Fevers by Fevers Concerns: I am bothered by fevers (episodes of high Fevers
body temperature).
C112563 FAMS01-I Am Bothered FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - Bothered by
by Headaches by Headaches I am bothered by headaches. Headaches
C112564 FAMS01-I Am Bothered FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - Bothered by
by Muscle Pains by Muscle Pains I am bothered by muscle pains. Muscle Pains
C112608 FAMS01-I Am Bothered FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Additional FAMS - Bothered by
by Muscle Spasms by Muscle Spasms Concerns: I am bothered by muscle spasms. Muscle Spasms
C112606 FAMS01-I Am Bothered FAMS01-I Am Bothered Functional Assessment of Multiple Sclerosis - Additional FAMS - Bothered by Chills
by the Chills by the Chills Concerns: I am bothered by the chills.
C112569 FAMS01-I Am Depressed FAMS01-I Am Depressed Functional Assessment of Multiple Sclerosis - Emotional FAMS - Depressed About
About My Condition About My Condition Well-Being: I am depressed about my condition. My Condition
C112596 FAMS01-I Am Forced to FAMS01-I Am Forced to Functional Assessment of Multiple Sclerosis - Additional FAMS - Forced to Spend
Spend Time in Bed Spend Time in Bed Concerns: I am forced to spend time in bed. Time in Bed
C112576 FAMS01-I Am Frustrated FAMS01-I Am Frustrated Functional Assessment of Multiple Sclerosis - General FAMS - I Am Frustrated
by My Condition by My Condition Contentment: I am frustrated by my condition. by My Condition
C112598 FAMS01-I Am Satisfied FAMS01-I Am Satisfied Functional Assessment of Multiple Sclerosis - Additional FAMS - Satisfied With My
With My Sex Life With My Sex Life Concerns: I am satisfied with my sex life. Sex Life
C112602 FAMS01-I Am Sleeping FAMS01-I Am Sleeping Functional Assessment of Multiple Sclerosis - Additional FAMS - I Am Sleeping
Well Well Concerns: I am sleeping well. Well
C112588 FAMS01-I Feel Close to FAMS01-I Feel Close to Functional Assessment of Multiple Sclerosis - FAMS - Feel Close to My
My Friends My Friends Family/Social Well-Being: I feel close to my friends. Friends
C112597 FAMS01-I Feel Close to FAMS01-I Feel Close to Functional Assessment of Multiple Sclerosis - Additional FAMS - Feel Close to My
My Partner My Partner Concerns: I feel close to my partner (or the person who is Partner
my main support).
C112560 FAMS01-I Feel Ill FAMS01-I Feel Ill Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Feel Ill
I feel ill.
C112594 FAMS01-I Feel Left Out of FAMS01-I Feel Left Out of Functional Assessment of Multiple Sclerosis - FAMS - Feel Left Out of
Things Things Family/Social Well-Being: I feel 'left out' of things. Things
page 611 of 1925

C112440 FAMS01TN
Code Value
C112578 FAMS01-I Feel Motivated FAMS01-I Feel Motivated Functional Assessment of Multiple Sclerosis - General FAMS - Feel Motivated to
to Do Things to Do Things Contentment: I feel motivated to do things. Do Things
C112600 FAMS01-I Feel Nervous FAMS01-I Feel Nervous Functional Assessment of Multiple Sclerosis - Additional FAMS - I Feel Nervous
Concerns: I feel nervous.
C112565 FAMS01-I Feel Sad FAMS01-I Feel Sad Functional Assessment of Multiple Sclerosis - Emotional FAMS - I Feel Sad
Well-Being: I feel sad.
C112580 FAMS01-I Feel Tired FAMS01-I Feel Tired Functional Assessment of Multiple Sclerosis - Thinking FAMS - I Feel Tired
and Fatigue: I feel tired.
C112568 FAMS01-I Feel Trapped FAMS01-I Feel Trapped Functional Assessment of Multiple Sclerosis - Emotional FAMS - Feel Trapped by
by My Condition by My Condition Well-Being: I feel trapped by my condition. My Condition
C112570 FAMS01-I Feel Useless FAMS01-I Feel Useless Functional Assessment of Multiple Sclerosis - Emotional FAMS - I Feel Useless
Well-Being: I feel useless.
C112561 FAMS01-I Feel Weak All FAMS01-I Feel Weak All Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Feel Weak All
Over Over I feel weak all over. Over
C112590 FAMS01-I Get Support FAMS01-I Get Support Functional Assessment of Multiple Sclerosis - FAMS - Get Support From
From My Friends From My Friends Family/Social Well-Being: I get support from my friends. Friends
C112579 FAMS01-I Have a Lack of FAMS01-I Have a Lack of Functional Assessment of Multiple Sclerosis - Thinking FAMS - Have a Lack of
Energy Energy and Fatigue: I have a lack of energy. Energy
C112573 FAMS01-I Have Accepted FAMS01-I Have Accepted Functional Assessment of Multiple Sclerosis - General FAMS - I Have Accepted
My Illness My Illness Contentment: I have accepted my illness. My Illness
C112558 FAMS01-I Have Nausea FAMS01-I Have Nausea Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Have Nausea
I have nausea.
C112559 FAMS01-I Have Pain FAMS01-I Have Pain Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Have Pain
I have pain.
C112562 FAMS01-I Have Pain in FAMS01-I Have Pain in Functional Assessment of Multiple Sclerosis - Symptoms: FAMS - I Have Pain in My
My Joints My Joints I have pain in my joints. Joints
C112555 FAMS01-I Have Strength FAMS01-I Have Strength Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - I Have Strength
in My Legs in My Legs have strength in my legs. in My Legs
C112585 FAMS01-I Have Trouble FAMS01-I Have Trouble Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble
Concentrating Concentrating and Fatigue: I have trouble concentrating. Concentrating
C112587 FAMS01-I Have Trouble FAMS01-I Have Trouble Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble Learning
Learning New Tasks Learning New Tasks and Fatigue: I have trouble learning new tasks or New Tasks or Directions
directions.
C112584 FAMS01-I Have Trouble FAMS01-I Have Trouble Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble
Remembering Things Remembering Things and Fatigue: I have trouble remembering things. Remembering Things
C112553 FAMS01-I Have Trouble FAMS01-I Have Trouble Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - I Have Trouble
Walking Walking have trouble walking. Walking
C112583 FAMS01-I Need to Rest FAMS01-I Need to Rest Functional Assessment of Multiple Sclerosis - Thinking FAMS - Need to Rest
During the Day During the Day and Fatigue: I need to rest during the day. During the Day
C112605 FAMS01-I Urinate More FAMS01-I Urinate More Functional Assessment of Multiple Sclerosis - Additional FAMS - Urinate More
Frequently Frequently Concerns: I urinate more frequently than usual. Frequently Than Usual
C112554 FAMS01-Limit My Social FAMS01-Limit My Social Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - Limit Social
Activity Activity have to limit my social activity because of my condition. Activity Because of
Condition
C112566 FAMS01-Losing Hope FAMS01-Losing Hope Functional Assessment of Multiple Sclerosis - Emotional FAMS - Losing Hope in
Against Illness Against Illness Well-Being: I am losing hope in the fight against my Fight Against My Illness
illness.
C112591 FAMS01-My Family Has FAMS01-My Family Has Functional Assessment of Multiple Sclerosis - FAMS - Family Has
Accepted My Illness Accepted My Illness Family/Social Well-Being: My family has accepted my Accepted My Illness
illness.
C112586 FAMS01-My Thinking Is FAMS01-My Thinking Is Functional Assessment of Multiple Sclerosis - Thinking FAMS - My Thinking is
Slower Than Before Slower Than Before and Fatigue: My thinking is slower than before. Slower Than Before
C112572 FAMS01-My Work Is FAMS01-My Work Is Functional Assessment of Multiple Sclerosis - General FAMS - My Work is
Fulfilling Fulfilling Contentment: My work (include work at home) is Fulfilling
fulfilling.
C112592 FAMS01-Satisfied FAMS01-Satisfied Functional Assessment of Multiple Sclerosis - FAMS - Satisfied With
Communication Illness Communication Illness Family/Social Well-Being: I am satisfied with family Family Communication
communication about my illness. About My Illness
page 612 of 1925

C112440 FAMS01TN
Code Value
C112599 FAMS01-Satisfied With FAMS01-Satisfied With Functional Assessment of Multiple Sclerosis - Additional FAMS - Satisfied With
How I Am Coping How I Am Coping Concerns: I am satisfied with how I am coping with my How I Am Coping With
illness. Illness
C112557 FAMS01-Take My FAMS01-Take My Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - Have to Take
Condition Into Account Condition Into Account have to take my condition into account when making Condition Into Account
plans. When Making Plans
C112582 FAMS01-Trouble Finishing FAMS01-Trouble Finishing Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble Finishing
Things Things and Fatigue: I have trouble finishing things because I am Things Because I Am
tired. Tired
C112556 FAMS01-Trouble Getting FAMS01-Trouble Getting Functional Assessment of Multiple Sclerosis - Mobility: I FAMS - Trouble Getting
Around in Public Around in Public have trouble getting around in public places. Around in Public Places
C112551 FAMS01-Trouble Meeting FAMS01-Trouble Meeting Functional Assessment of Multiple Sclerosis - Mobility: FAMS - Have Trouble
Needs of Family Needs of Family Because of my physical condition, I have trouble meeting Meeting Needs of Family
the needs of my family. Because of My Condition
C112581 FAMS01-Trouble Starting FAMS01-Trouble Starting Functional Assessment of Multiple Sclerosis - Thinking FAMS - Trouble Starting
Things Things and Fatigue: I have trouble starting things because I am Things Because I Am
tired. Tired
C112593 FAMS01-Trouble FAMS01-Trouble Functional Assessment of Multiple Sclerosis - FAMS - Family Has
Understanding Worsening Understanding Worsening Family/Social Well-Being: My family has trouble Trouble Understanding
understanding when my condition gets worse. When My Condition Gets
Worse
C112601 FAMS01-Worry My FAMS01-Worry My Functional Assessment of Multiple Sclerosis - Additional FAMS - Worry My
Condition Will Get Worse Condition Will Get Worse Concerns: I worry that my condition will get worse. Condition Will Get Worse
page 613 of 1925

FAQ01TC (Functional Activities Questionnaire Test Code)
C111344 FAQ01TC
Code Value
C111499 FAQ0101 FAQ01-Write Checks/Pay Functional Activities Questionnaire - Writing checks, FAQ - Write checks, Pay
Bills/Checkbook paying bills, balancing checkbook. bills, Balance checkbook
C111500 FAQ0102 FAQ01-Assembling Functional Activities Questionnaire - Assembling tax FAQ - Assemble
records, business affairs, or papers.
C111501 FAQ0103 FAQ01-Shopping Alone Functional Activities Questionnaire - Shopping alone for FAQ - Shop Alone
clothes, household necessities, or groceries.
C111502 FAQ0104 FAQ01-Playing a Game of Functional Activities Questionnaire - Playing a game of FAQ - Play Game of Skill,
Skill skill, working on a hobby. Work on Hobby
C111503 FAQ0105 FAQ01-Heat Water/Make Functional Activities Questionnaire - Heating water, FAQ - Heat water, Make
Coffee/Stove Off making a cup of coffee, turning off stove after use. Coffee, Turn Off Stove
C111504 FAQ0106 FAQ01-Preparing a Functional Activities Questionnaire - Preparing a balanced FAQ - Prepare a Meal
Balanced Meal meal.
C111505 FAQ0107 FAQ01-Keeping Track of Functional Activities Questionnaire - Keeping track of FAQ - Keep Track of
Current Events current events. Current Events
C111506 FAQ0108 FAQ01-Paying Attention Functional Activities Questionnaire - Paying attention to, FAQ - Pay Attention,
understanding, discussing TV, book, magazine. Understand, Discuss
C111507 FAQ0109 FAQ01-Remembering Functional Activities Questionnaire - Remembering FAQ - Remember

appointments, family occasions, holidays, medications.
C111508 FAQ0110 FAQ01-Traveling Functional Activities Questionnaire - Traveling out of FAQ - Travel
neighborhood, driving, arranging to take buses.
C111509 FAQ0111 FAQ01-Total Score Functional Activities Questionnaire - Total Score. FAQ - Total Score
page 614 of 1925

FAQ01TN (Functional Activities Questionnaire Test Name)
C111343 FAQ01TN
Code Value
C111500 FAQ01-Assembling FAQ01-Assembling Functional Activities Questionnaire - Assembling tax FAQ - Assemble
records, business affairs, or papers.
C111503 FAQ01-Heat Water/Make FAQ01-Heat Water/Make Functional Activities Questionnaire - Heating water, FAQ - Heat water, Make
Coffee/Stove Off Coffee/Stove Off making a cup of coffee, turning off stove after use. Coffee, Turn Off Stove
C111505 FAQ01-Keeping Track of FAQ01-Keeping Track of Functional Activities Questionnaire - Keeping track of FAQ - Keep Track of
Current Events Current Events current events. Current Events
C111506 FAQ01-Paying Attention FAQ01-Paying Attention Functional Activities Questionnaire - Paying attention to, FAQ - Pay Attention,
understanding, discussing TV, book, magazine. Understand, Discuss
C111502 FAQ01-Playing a Game of FAQ01-Playing a Game of Functional Activities Questionnaire - Playing a game of FAQ - Play Game of Skill,
Skill Skill skill, working on a hobby. Work on Hobby
C111504 FAQ01-Preparing a FAQ01-Preparing a Functional Activities Questionnaire - Preparing a balanced FAQ - Prepare a Meal
Balanced Meal Balanced Meal meal.
C111507 FAQ01-Remembering FAQ01-Remembering Functional Activities Questionnaire - Remembering FAQ - Remember

appointments, family occasions, holidays, medications.
C111501 FAQ01-Shopping Alone FAQ01-Shopping Alone Functional Activities Questionnaire - Shopping alone for FAQ - Shop Alone
clothes, household necessities, or groceries.
C111509 FAQ01-Total Score FAQ01-Total Score Functional Activities Questionnaire - Total Score. FAQ - Total Score
C111508 FAQ01-Traveling FAQ01-Traveling Functional Activities Questionnaire - Traveling out of FAQ - Travel
neighborhood, driving, arranging to take buses.
C111499 FAQ01-Write Checks/Pay FAQ01-Write Checks/Pay Functional Activities Questionnaire - Writing checks, FAQ - Write checks, Pay
Bills/Checkbook Bills/Checkbook paying bills, balancing checkbook. bills, Balance checkbook
page 615 of 1925

FAQ02TC (Functional Activities Questionnaire-NACC Version Questionnaire Test Code)
C111346 FAQ02TC
Code Value
C111510 FAQ0201 FAQ02-Write Checks/Pay Functional Activities Questionnaire-NACC - Writing FAQ-NACC Version -
Bills/Checkbook checks, paying bills, or balancing a checkbook. Write checks, Pay bills,
Balance checkbook
C111511 FAQ0202 FAQ02-Assembling Functional Activities Questionnaire-NACC - Assembling FAQ-NACC Version -

tax records, business affairs, or other papers. Assemble
C111512 FAQ0203 FAQ02-Shopping Alone Functional Activities Questionnaire-NACC - Shopping FAQ-NACC Version - Shop
alone for clothes, household necessities, or groceries. Alone
C111513 FAQ0204 FAQ02-Playing a Game of Functional Activities Questionnaire-NACC - Playing a FAQ-NACC Version - Play
Skill game of skill such as bridge or chess, working on a Game of Skill, Work on
hobby. Hobby
C111514 FAQ0205 FAQ02-Heat Water/Make Functional Activities Questionnaire-NACC - Heating water, FAQ-NACC Version - Heat
Coffee/Stove Off making a cup of coffee, turning off the stove. water, Make Coffee, Turn
Off Stove
C111515 FAQ0206 FAQ02-Preparing a Functional Activities Questionnaire-NACC - Preparing a FAQ-NACC Version -

Balanced Meal balanced meal. Prepare a Meal
C111516 FAQ0207 FAQ02-Keeping Track of Functional Activities Questionnaire-NACC - Keeping track FAQ-NACC Version - Keep
Current Events of current events. Track of Current Events
C111517 FAQ0208 FAQ02-Paying Attention Functional Activities Questionnaire-NACC - Paying FAQ-NACC Version - Pay
attention to and understanding a TV program, book, or Attention, Understand,
magazine. Discuss
C111518 FAQ0209 FAQ02-Remembering Functional Activities Questionnaire-NACC - Remembering FAQ-NACC Version -

appointments, family occasions, holidays, medications. Remember
C111519 FAQ0210 FAQ02-Traveling Functional Activities Questionnaire-NACC - Traveling out FAQ-NACC Version -
of the neighborhood, driving, or arranging to take public Travel
transportation.
page 616 of 1925

FAQ02TN (Functional Activities Questionnaire-NACC Version Questionnaire Test Name)
C111345 FAQ02TN
Code Value
C111511 FAQ02-Assembling FAQ02-Assembling Functional Activities Questionnaire-NACC - Assembling FAQ-NACC Version -

tax records, business affairs, or other papers. Assemble
C111514 FAQ02-Heat Water/Make FAQ02-Heat Water/Make Functional Activities Questionnaire-NACC - Heating water, FAQ-NACC Version - Heat
Coffee/Stove Off Coffee/Stove Off making a cup of coffee, turning off the stove. water, Make Coffee, Turn
Off Stove
C111516 FAQ02-Keeping Track of FAQ02-Keeping Track of Functional Activities Questionnaire-NACC - Keeping track FAQ-NACC Version - Keep
Current Events Current Events of current events. Track of Current Events
C111517 FAQ02-Paying Attention FAQ02-Paying Attention Functional Activities Questionnaire-NACC - Paying FAQ-NACC Version - Pay
attention to and understanding a TV program, book, or Attention, Understand,
magazine. Discuss
C111513 FAQ02-Playing a Game of FAQ02-Playing a Game of Functional Activities Questionnaire-NACC - Playing a FAQ-NACC Version - Play
Skill Skill game of skill such as bridge or chess, working on a Game of Skill, Work on
hobby. Hobby
C111515 FAQ02-Preparing a FAQ02-Preparing a Functional Activities Questionnaire-NACC - Preparing a FAQ-NACC Version -

Balanced Meal Balanced Meal balanced meal. Prepare a Meal
C111518 FAQ02-Remembering FAQ02-Remembering Functional Activities Questionnaire-NACC - Remembering FAQ-NACC Version -

appointments, family occasions, holidays, medications. Remember
C111512 FAQ02-Shopping Alone FAQ02-Shopping Alone Functional Activities Questionnaire-NACC - Shopping FAQ-NACC Version - Shop
alone for clothes, household necessities, or groceries. Alone
C111519 FAQ02-Traveling FAQ02-Traveling Functional Activities Questionnaire-NACC - Traveling out FAQ-NACC Version -
of the neighborhood, driving, or arranging to take public Travel
transportation.
C111510 FAQ02-Write Checks/Pay FAQ02-Write Checks/Pay Functional Activities Questionnaire-NACC - Writing FAQ-NACC Version -
Bills/Checkbook Bills/Checkbook checks, paying bills, or balancing a checkbook. Write checks, Pay bills,
Balance checkbook
page 617 of 1925

FCVD1TC (Framingham Heart Study Cardiovascular Disease 10-Year Risk Score Clinical Classification
Test Code)
C124670 FCVD1TC
Code Value
C124722 FCVD101 FCVD1-Framingham CVD Framingham Heart Study Cardiovascular Disease 10-Year FHS CVD 10-Year Risk
10-Year Risk Score Risk Score - Cardiovascular disease 10-year risk score. Score - Risk Score
page 618 of 1925

FCVD1TN (Framingham Heart Study Cardiovascular Disease 10-Year Risk Score Clinical Classification
Test Name)
C124669 FCVD1TN
Code Value
C124722 FCVD1-Framingham CVD FCVD1-Framingham CVD Framingham Heart Study Cardiovascular Disease 10-Year FHS CVD 10-Year Risk
10-Year Risk Score 10-Year Risk Score Risk Score - Cardiovascular disease 10-year risk score. Score - Risk Score
page 619 of 1925

FIQR01TC (Revised Fibromyalgia Impact Questionnaire Questionnaire Test Code)
C103465 FIQR01TC
Code Value
C103544 FIQR0101 FIQR01-Brush or Comb Revised Fibromyalgia Impact Questionnaire - Brush or FIQR - Brush or Comb
Your Hair comb your hair. Your Hair
C103545 FIQR0102 FIQR01-Walk Revised Fibromyalgia Impact Questionnaire - Walk FIQR - Walk Continuously
Continuously for 20 continuously for 20 minutes. for 20 Minutes
Minutes
C103546 FIQR0103 FIQR01-Prepare a Revised Fibromyalgia Impact Questionnaire - Prepare a FIQR - Prepare a
Homemade Meal homemade meal. Homemade Meal
C103547 FIQR0104 FIQR01-Vacuum Scrub or Revised Fibromyalgia Impact Questionnaire - Vacuum, FIQR - Vacuum Scrub or
Sweep Floors scrub or sweep floors. Sweep Floors
C103548 FIQR0105 FIQR01-Lift/Carry Bag Revised Fibromyalgia Impact Questionnaire - Lift and FIQR - Lift and Carry a
Full of Groceries carry a bag full of groceries. Bag Full of Groceries
C103549 FIQR0106 FIQR01-Climb One Flight Revised Fibromyalgia Impact Questionnaire - Climb one FIQR - Climb One Flight
of Stairs flight of stairs. of Stairs
C103550 FIQR0107 FIQR01-Change Bed Revised Fibromyalgia Impact Questionnaire - Change bed FIQR - Change Bed
Sheets sheets. Sheets
C103551 FIQR0108 FIQR01-Sit in a Chair for Revised Fibromyalgia Impact Questionnaire - Sit in a FIQR - Sit in a Chair for
45 Minutes chair for 45 minutes. 45 Minutes
C103552 FIQR0109 FIQR01-Go Shopping for Revised Fibromyalgia Impact Questionnaire - Go shopping FIQR - Go Shopping for
Groceries for groceries. Groceries
C103553 FIQR0110 FIQR01-Fibromyalgia Revised Fibromyalgia Impact Questionnaire - FIQR - Fibromyalgia

Prevented Goals Fibromyalgia prevented me from accomplishing goals for Prevented Me from
the week. Accomplishing Goals for
the Week
C103554 FIQR0111 FIQR01-Overwhelmed by Revised Fibromyalgia Impact Questionnaire - I was FIQR - I was Completely
Fibromyalgia completely overwhelmed by my fibromyalgia symptoms. Overwhelmed by My
Fibromyalgia Symptoms
C103555 FIQR0112 FIQR01-Pain Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Pain
your level of pain.
C103556 FIQR0113 FIQR01-Energy Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Energy
your level of energy.
C103557 FIQR0114 FIQR01-Stiffness Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Stiffness
your level of stiffness.
C103558 FIQR0115 FIQR01-Your Sleep Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Your Sleep
the quality of your sleep.
C103559 FIQR0116 FIQR01-Depression Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Depression
your level of depression.
C103560 FIQR0117 FIQR01-Memory Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Memory Problems
Problems your level of memory problems.
C103561 FIQR0118 FIQR01-Anxiety Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Anxiety
your level of anxiety.
C103562 FIQR0119 FIQR01-Tenderness to Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Tenderness to
Touch your level of tenderness to touch. Touch
C103563 FIQR0120 FIQR01-Balance Problems Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Balance Problems
your level of balance problems.
C103564 FIQR0121 FIQR01-Sensitivity Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Sensitivity to Loud
Noise/Light/Odor/Cold your level of sensitivity to loud noises, bright lights, odors Noises, Bright Lights,
and cold. Odors and Cold
C118107 FIQR0122 FIQR01-Activities Sub- Revised Fibromyalgia Impact Questionnaire - Sub-total FIQR - Activities Sub-
Total for activities subcategory. Total
C118108 FIQR0123 FIQR01-Overall Impact Revised Fibromyalgia Impact Questionnaire - Sub-total FIQR - Overall Impact
Sub-Total for overall impact subcategory. Sub-Total
C118109 FIQR0124 FIQR01-Symptoms Sub- Revised Fibromyalgia Impact Questionnaire - Sub-total FIQR - Symptoms Sub-
Total for symptoms subcategory. Total
C118110 FIQR0125 FIQR01-FIQR Total Revised Fibromyalgia Impact Questionnaire - FIQR total. FIQR - FIQR Total
page 620 of 1925

FIQR01TN (Revised Fibromyalgia Impact Questionnaire Questionnaire Test Name)
C103464 FIQR01TN
Code Value
C118107 FIQR01-Activities Sub- FIQR01-Activities Sub- Revised Fibromyalgia Impact Questionnaire - Sub-total FIQR - Activities Sub-
Total Total for activities subcategory. Total
C103561 FIQR01-Anxiety FIQR01-Anxiety Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Anxiety
your level of anxiety.
C103563 FIQR01-Balance Problems FIQR01-Balance Problems Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Balance Problems
your level of balance problems.
C103544 FIQR01-Brush or Comb FIQR01-Brush or Comb Revised Fibromyalgia Impact Questionnaire - Brush or FIQR - Brush or Comb
Your Hair Your Hair comb your hair. Your Hair
C103550 FIQR01-Change Bed FIQR01-Change Bed Revised Fibromyalgia Impact Questionnaire - Change bed FIQR - Change Bed
Sheets Sheets sheets. Sheets
C103549 FIQR01-Climb One Flight FIQR01-Climb One Flight Revised Fibromyalgia Impact Questionnaire - Climb one FIQR - Climb One Flight
of Stairs of Stairs flight of stairs. of Stairs
C103559 FIQR01-Depression FIQR01-Depression Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Depression
your level of depression.
C103556 FIQR01-Energy FIQR01-Energy Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Energy
your level of energy.
C103553 FIQR01-Fibromyalgia FIQR01-Fibromyalgia Revised Fibromyalgia Impact Questionnaire - FIQR - Fibromyalgia

Prevented Goals Prevented Goals Fibromyalgia prevented me from accomplishing goals for Prevented Me from
the week. Accomplishing Goals for
the Week
C118110 FIQR01-FIQR Total FIQR01-FIQR Total Revised Fibromyalgia Impact Questionnaire - FIQR total. FIQR - FIQR Total
C103552 FIQR01-Go Shopping for FIQR01-Go Shopping for Revised Fibromyalgia Impact Questionnaire - Go shopping FIQR - Go Shopping for
Groceries Groceries for groceries. Groceries
C103548 FIQR01-Lift/Carry Bag FIQR01-Lift/Carry Bag Revised Fibromyalgia Impact Questionnaire - Lift and FIQR - Lift and Carry a
Full of Groceries Full of Groceries carry a bag full of groceries. Bag Full of Groceries
C103560 FIQR01-Memory FIQR01-Memory Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Memory Problems
Problems Problems your level of memory problems.
C118108 FIQR01-Overall Impact FIQR01-Overall Impact Revised Fibromyalgia Impact Questionnaire - Sub-total FIQR - Overall Impact
Sub-Total Sub-Total for overall impact subcategory. Sub-Total
C103554 FIQR01-Overwhelmed by FIQR01-Overwhelmed by Revised Fibromyalgia Impact Questionnaire - I was FIQR - I was Completely
Fibromyalgia Fibromyalgia completely overwhelmed by my fibromyalgia symptoms. Overwhelmed by My
Fibromyalgia Symptoms
C103555 FIQR01-Pain FIQR01-Pain Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Pain
your level of pain.
C103546 FIQR01-Prepare a FIQR01-Prepare a Revised Fibromyalgia Impact Questionnaire - Prepare a FIQR - Prepare a
Homemade Meal Homemade Meal homemade meal. Homemade Meal
C103564 FIQR01-Sensitivity FIQR01-Sensitivity Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Sensitivity to Loud
Noise/Light/Odor/Cold Noise/Light/Odor/Cold your level of sensitivity to loud noises, bright lights, odors Noises, Bright Lights,
and cold. Odors and Cold
C103551 FIQR01-Sit in a Chair for FIQR01-Sit in a Chair for Revised Fibromyalgia Impact Questionnaire - Sit in a FIQR - Sit in a Chair for
45 Minutes 45 Minutes chair for 45 minutes. 45 Minutes
C103557 FIQR01-Stiffness FIQR01-Stiffness Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Stiffness
your level of stiffness.
C118109 FIQR01-Symptoms Sub- FIQR01-Symptoms Sub- Revised Fibromyalgia Impact Questionnaire - Sub-total FIQR - Symptoms Sub-
Total Total for symptoms subcategory. Total
C103562 FIQR01-Tenderness to FIQR01-Tenderness to Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Tenderness to
Touch Touch your level of tenderness to touch. Touch
C103547 FIQR01-Vacuum Scrub or FIQR01-Vacuum Scrub or Revised Fibromyalgia Impact Questionnaire - Vacuum, FIQR - Vacuum Scrub or
Sweep Floors Sweep Floors scrub or sweep floors. Sweep Floors
C103545 FIQR01-Walk FIQR01-Walk Revised Fibromyalgia Impact Questionnaire - Walk FIQR - Walk Continuously
Continuously for 20 Continuously for 20 continuously for 20 minutes. for 20 Minutes
Minutes Minutes
C103558 FIQR01-Your Sleep FIQR01-Your Sleep Revised Fibromyalgia Impact Questionnaire - Please rate FIQR - Your Sleep
the quality of your sleep.
page 621 of 1925

FPSR1TC (Faces Pain Scale - Revised Questionnaire Test Code)
C100154 FPSR1TC
Code Value
C101013 FPSR101 FPSR1-How Much Do You Faces Pain Scale - Revised - Point to the face that shows FPSR - How Much Do You
Hurt how much you hurt [right now]. Hurt
page 622 of 1925

FPSR1TN (Faces Pain Scale - Revised Questionnaire Test Name)
C100153 FPSR1TN
Code Value
C101013 FPSR1-How Much Do You FPSR1-How Much Do You Faces Pain Scale - Revised - Point to the face that shows FPSR - How Much Do You
Hurt Hurt how much you hurt [right now]. Hurt
page 623 of 1925

FREQ (Frequency)
C71113 FREQ
Code Value
C64526 1 TIME PER WEEK One Time Per Week One time per week. (NCI) Once Weekly
C139179 10 DAYS PER MONTH 10 Days Monthly Ten days per month. (NCI) Ten Days Per Month
C64497 2 TIMES PER WEEK BIS;Twice per week Two times per week. (NCI) Twice Weekly
C98861 2 TIMES PER YEAR 2 Times Per Year Two times per year. (NCI) Two Times Yearly
C98859 3 TIMES PER MONTH 3 Times Per Month Three times per month. (NCI) Three Times Monthly
C64528 3 TIMES PER WEEK TIS;Three times a week Three times per week. (NCI) Three Times Weekly
C98860 3 TIMES PER YEAR 3 Times Per Year Three times per year. (NCI) Three Times Yearly
C98852 4 TIMES PER MONTH 4 Times Per Month Four times per month. (NCI) Four Times Monthly
C64531 4 TIMES PER WEEK 4 times per week;QIS Four times per week. (NCI) Four Times Weekly
C98853 4 TIMES PER YEAR 4 Times Per Year Four times per year. (NCI) Four Times Yearly
C98849 5 TIMES PER DAY 5 Times Daily Five times per day. (NCI) Five Times Daily
C98850 5 TIMES PER MONTH 5 Times Per Month Five times per month. (NCI) Five Times Monthly
C85552 5 TIMES PER WEEK 5 Times Per Week Five times per week. (NCI) Five Times Weekly
C98851 5 TIMES PER YEAR 5 Times Per Year Five times per year. (NCI) Five Times Yearly
C98855 6 TIMES PER DAY 6 Times Daily Six times per day. (NCI) Six Times Daily
C98856 6 TIMES PER MONTH 6 Times Per Month Six times per month. (NCI) Six Times Monthly
C98857 6 TIMES PER WEEK 6 Times Per Week Six times per week. (NCI) Six Times Weekly
C98858 6 TIMES PER YEAR 6 Times Per Year Six times per year. (NCI) Six Times Yearly
C139180 7 TIMES PER DAY 7 Times Daily Seven times per day. (NCI) Seven Times Per Day
C98854 7 TIMES PER WEEK 7 Times Per Week Seven times per week. (NCI) Seven Times Weekly
C139181 8 TIMES PER DAY 8 Times Daily Eight times per day. (NCI) Eight Times Per Day
C139182 9 TIMES PER DAY 9 Times Daily Nine times per day. (NCI) Nine Times Per Day
C64636 AD LIBITUM Ad Libitum As much as desired. As Much as Desired
C64496 BID BD;Twice per day Two times per day, at unspecified times. (NCI) Twice Daily
C71129 BIM Twice per month Twice per month. (NCI) Twice Per Month
C53279 CONTINUOUS Continuous Remain in force or carry on without letup; keep or Continue
maintain in unaltered condition; exist in time or space
without stop or interruption. (NCI)
C71127 EVERY 2 WEEKS Every 2 weeks;Q2S Every two weeks. (NCI) Every Two Weeks
C64535 EVERY 3 WEEKS Every 3 weeks;Q3S Every three weeks. (NCI) Every Three Weeks
C64529 EVERY 4 WEEKS Every 4 weeks;Q4S Every four weeks. (NCI) Every Four Weeks
C103390 EVERY 5 WEEKS Every 5 weeks;Q5S Every five weeks. (NCI) Every Five Weeks
C89788 EVERY 6 WEEKS Every 6 Weeks;Q6S Every six weeks. (NCI) Every Six Weeks
C116149 EVERY 7 WEEKS Every 7 weeks;Q7S Every seven weeks. Every Seven Weeks
C103389 EVERY 8 WEEKS Every 8 weeks;Q8S Every eight weeks. (NCI) Every Eight Weeks
C67069 EVERY WEEK Every week;Per Week;QS Every week. (NCI) Weekly
C71325 INTERMITTENT Intermittent Periodically stopping and starting. (NCI) Intermittent
C64954 OCCASIONAL Occasional Not occurring regularly or at short intervals. Infrequent
C64576 ONCE One time. Once
page 624 of 1925

C71113 FREQ
Code Value
C74924 PA /Year;Every Year;Per A frequency rate of occurrences of something within a Per Year
Annum;Per Year period of time equal to three hundred sixty-five days.
C64499 PRN As needed As needed. (NCI) As Necessary
C64500 Q10H Every 10 hours Every ten hours. (NCI) Every Ten Hours
C64501 Q11H Every 11 hours Every eleven hours. (NCI) Every Eleven Hours
C64502 Q12H Every 12 hours Every twelve hours. (NCI) Every Twelve Hours
C64503 Q13H Every 13 hours Every thirteen hours. (NCI) Every Thirteen Hours
C64504 Q14H Every 14 hours Every fourteen hours. (NCI) Every Fourteen Hours
C64505 Q15H Every 15 hours Every fifteen hours. (NCI) Every Fifteen Hours
C64506 Q16H Every 16 hours Every sixteen hours. (NCI) Every Sixteen Hours
C64507 Q17H Every 17 hours Every seventeen hours. (NCI) Every Seventeen Hours
C64508 Q18H Every 18 hours Every eighteen hours. (NCI) Every Eighteen Hours
C64509 Q19H Every 19 hours Every nineteen hours. (NCI) Every Nineteen Hours
C64511 Q20H Every 20 hours Every twenty hours. (NCI) Every Twenty Hours
C64512 Q21H Every 21 hours Every twenty-one hours. (NCI) Every Twenty-One Hours
C64513 Q22H Every 22 hours Every twenty-two hours. (NCI) Every Twenty-Two Hours
C64514 Q23H Every 23 hours Every twenty-three hours. (NCI) Every Twenty-Three
Hours
C64515 Q24H Every 24 hours Every twenty-four hours. (NCI) Every Twenty-Four Hours
C64516 Q2H Every 2 hours Every two hours. (NCI) Every Two Hours
C64536 Q2M Every two months Every two months. (NCI) Every Two Months
C89791 Q36H Every 36 Hours Every thirty-six hours. (NCI) Every Thirty-six Hours
C64533 Q3D Every 3 days Every three days. (NCI) Every Three Days
C64517 Q3H Every 3 hours Every three hours. (NCI) Every Three Hours
C64537 Q3M Every 3 months Every three months. (NCI) Every Three Months
C139183 Q45MIN Every 45 Minutes Every forty-five minutes. (NCI) Every Forty-Five Minutes
C89790 Q48H Every 48 Hours Every forty-eight hours. (NCI) Every Forty-eight Hours
C64534 Q4D Every 4 days Every four days. (NCI) Every Four Days
C64518 Q4H Every 4 hours Every four hours. (NCI) Every Four Hours
C64538 Q4M Every 4 months Every four months. (NCI) Every Four Months
C71124 Q5D Every 5 days Every five days. (NCI) Every Five Days
C64519 Q5H Every 5 hours Every five hours. (NCI) Every Five Hours
C64520 Q6H Every 6 hours Every six hours. (NCI) Every Six Hours
C89789 Q6M Every 6 Months Every six months. (NCI) Every Six Months
C139177 Q7D Every 7 Days Every seven days. (NCI) Every Seven Days
C64521 Q7H Every 7 hours Every seven hours. (NCI) Every Seven Hours
C64523 Q8H Every 8 hours Every eight hours. (NCI) Every Eight Hours
C64524 Q9H Every 9 hours Every nine hours. (NCI) Every Nine Hours
C64595 QAM Every morning. (NCI) Every Morning
C25473 QD Daily A rate of occurrences within a period of time equal to one Daily
day.
C64510 QH Every hour Every hour. (NCI) Every Hour
page 625 of 1925

C71113 FREQ
Code Value
C64530 QID 4 times per day Four times per day. (NCI) Four Times Daily
C64498 QM Every Month;Per Month Every month. (NCI) Monthly
C139178 QN Every night. Every Night.
C64525 QOD Every other day Every other day. (NCI) Every Other Day
C64596 QPM Every evening. (NCI) Every Evening
C64527 TID 3 times per day Three times per day. (NCI) Three Times Daily
C65134 TWICE Two times. (NCI) Twice
page 626 of 1925

FRM (Pharmaceutical Dosage Form)
C66726 FRM
Code Value
C42887 AEROSOL aer A product that is packaged under pressure and contains Aerosol Dosage Form
therapeutically active ingredients that are released upon
activation of an appropriate valve system; it is intended
for topical application to the skin as well as local
application into the nose (nasal aerosols), mouth (lingual
aerosols), or lungs (inhalation aerosols).
C42888 AEROSOL, FOAM A dosage form containing one or more active ingredients, Aerosol Foam Dosage
surfactants, aqueous or non-aqueous liquids, and the Form
propellants; if the propellant is in the internal
(discontinuous) phase (i.e., of the oil-in-water type), a
stable foam is discharged, and if the propellant is in the
external (continuous) phase (i.e., of the water-in-oil
type), a spray or a quick-breaking foam is discharged.
C42960 AEROSOL, METERED A pressurized dosage form consisting of metered dose Metered Aerosol Dosage
valves which allow for the delivery of a uniform quantity Form
of spray upon each activation. (NCI)
C42971 AEROSOL, POWDER A product that is packaged under pressure and contains Powder Aerosol Dosage
therapeutically active ingredients, in the form of a Form
powder, that are released upon activation of an
appropriate valve system. (NCI)
C42889 AEROSOL, SPRAY An aerosol product which utilizes a compressed gas as Aerosol Spray Dosage
the propellant to provide the force necessary to expel the Form
product as a wet spray; it is applicable to solutions of
medicinal agents in aqueous solvents. (NCI)
C42892 BAR, CHEWABLE A solid dosage form usually in the form of a rectangle Chewable Bar Dosage
that is meant to be chewed. (NCI) Form
C42890 BEAD A solid dosage form in the shape of a small ball. (NCI) Bead Dosage Form
C43451 BEAD, IMPLANT, A small sterile solid mass consisting of a highly purified Extended Release Bead
EXTENDED RELEASE drug intended for implantation in the body which would Implant Dosage Form
allow at least a reduction in dosing frequency as
compared to that drug presented as a conventional
dosage form. (NCI)
C42891 BLOCK Solid dosage form, usually in the shape of a square or Block Dosage Form
rectangle. (NCI)
C97197 CAPLET A solid dosage form in which a tablet has been compacted Caplet Dosage Form
into capsule shape.
C25158 CAPSULE cap A solid pharmaceutical dosage form that contains Capsule Dosage Form
medicinal agent within either a hard or soft soluble
container or shell, usually used for the oral administration
of medicine. The shells are made of a suitable form of
gelatin or other substance. (NCI)
C42895 CAPSULE, COATED A solid dosage form in which the drug is enclosed within Coated Capsule Dosage
either a hard or soft soluble container or "shell" made Form
from a suitable form of gelatin; additionally, the capsule
is covered in a designated coating.
C42896 CAPSULE, COATED A solid dosage form in which the drug is enclosed within Coated Pellet in Capsule
PELLETS either a hard or soft soluble container or 'shell' made Dosage Form
from a suitable form of gelatin; the drug itself is in the
form of granules to which varying amounts of coating
have been applied. (NCI)
C42917 CAPSULE, COATED, A solid dosage form in which the drug is enclosed within Extended Release Coated
EXTENDED RELEASE either a hard or soft soluble container or "shell" made Capsule Dosage Form
from a suitable form of gelatin; additionally, the capsule
is covered in a designated coating, and which releases a
drug (or drugs) in such a manner to allow at least a
reduction in dosing frequency as compared to that drug
(or drugs) presented as a conventional dosage form.
C42902 CAPSULE, DELAYED A solid dosage form in which the drug is enclosed within Delayed Release Capsule
RELEASE either a hard or soft soluble container made from a Dosage Form
suitable form of gelatin, and which releases a drug (or
drugs) at a time other than promptly after administration.
Enteric-coated articles are delayed release dosage forms.
(NCI)
page 627 of 1925

C66726 FRM
Code Value
C42904 CAPSULE, DELAYED A solid dosage form in which the drug is enclosed within Delayed Release Pellet in
RELEASE PELLETS either a hard or soft soluble container or "shell" made Capsule Dosage Form
from a suitable form of gelatin; the drug itself is in the
form of granules to which enteric coating has been
applied, thus delaying release of the drug until its
passage into the intestines.
C42916 CAPSULE, EXTENDED A solid dosage form in which the drug is enclosed within Extended Release
RELEASE either a hard or soft soluble container made from a Capsule Dosage Form
suitable form of gelatin, and which releases a drug (or
drugs) in such a manner to allow a reduction in dosing
frequency as compared to that drug (or drugs) presented
as a conventional dosage form. (NCI)
C42928 CAPSULE, FILM COATED, A solid dosage form in which the drug is enclosed within Extended Release Film
EXTENDED RELEASE either a hard or soft soluble container or 'shell' made Coated Capsule Dosage
from a suitable form of gelatin; additionally, the capsule Form
is covered in a designated film coating, and which
releases a drug (or drugs) in such a manner to allow at
least a reduction in dosing frequency as compared to that
drug (or drugs) presented as a conventional dosage form.
C42936 CAPSULE, GELATIN A solid dosage form in which the drug is enclosed within Gelatin Coated Capsule
COATED either a hard or soft soluble container made from a Dosage Form
suitable form of gelatin; through a banding process, the
capsule is coated with additional layers of gelatin so as to
form a complete seal. (NCI)
C142247 CAPSULE, IMMEDIATE A solid dosage form in which the drug is enclosed within Immediate Release
RELEASE either a hard or soft soluble container, which is designed Capsule Dosage Form
to release its active and/or inert ingredient(s)
immediately upon administration.
C42954 CAPSULE, LIQUID FILLED A solid dosage form in which the drug is enclosed within a Liquid Filled Capsule
soluble, gelatin shell which is plasticized by the addition Dosage Form
of a polyol, such as sorbitol or glycerin, and is therefore
of a somewhat thicker consistency than that of a hard
shell capsule; typically, the active ingredients are
dissolved or suspended in a liquid vehicle. (NCI)
C45414 CEMENT A substance that serves to produce solid union between Cement Dosage Form
two surfaces. (NCI)
C42678 CIGARETTE A narrow tube filled with material that is capable to burn Cigarette Dosage Form
with release of therapeutically-active substance(s) during
the process of smoking. Cigarette is a very efficient drug-
delivery inhaler system for fast-acting substances.
C60884 CLOTH A large piece of relatively flat, absorbent material that Cloth Dosage Form
contains a drug. It is typically used for applying
medication or for cleansing.
C60891 CONCENTRATE A liquid preparation of increased strength and reduced Concentrated Dosage
volume which is usually diluted prior to administration. Form
(NCI)
C42900 CONE A solid dosage form bounded by a circular base and the Cone Dosage Form
surface formed by line segments joining every point of
the boundary of the base to a common vertex. A cone
(usually containing antibiotics) is normally placed below
the gingiva after a dental extraction. (NCI)
C42919 CORE, EXTENDED An ocular system placed in the eye from which the drug Extended Release Core
RELEASE diffuses through a membrane at a constant rate over a Dosage Form
specified period. (NCI)
C28944 CREAM A semisolid emulsion of either the oil-in-water or the Cream Dosage Form
water-in-oil type, ordinarily intended for topical use.
(NCI)
C60897 CREAM, AUGMENTED A cream dosage form that enhances drug delivery. Augmented Cream
Augmentation does not refer to the strength of the drug Dosage Form
in the dosage form. NOTE: CDER has decided to refrain
from expanding the use of this dosage form due to
difficulties in setting specific criteria that must be met to
be considered augmented.
C42901 CRYSTAL A naturally produced angular solid of definite form in Crystal Dosage Form
which the ultimate units from which it is built up are
systematically arranged; they are usually evenly spaced
on a regular space lattice.
C45415 CULTURE The propagation of microorganisms or of living tissue Culture Dosage Form
cells in special media conducive to their growth. (NCI)
page 628 of 1925

C66726 FRM
Code Value
C47890 DIAPHRAGM A device usually dome-shaped, worn during copulation Vaginal Diaphragm
over the cervical mouth for prevention of conception or Dosage Form
infection. (NCI)
C43525 DISC A circular plate-like organ or structure. Disc Dosage Form
C42679 DOUCHE A liquid preparation, intended for the irrigative cleansing Douche Dosage Form
of the vagina, that is prepared from powders, liquid
solutions, or liquid concentrates and contains one or more
chemical substances dissolved in a suitable solvent or
mutually miscible solvents. (NCI)
C42763 DRESSING The application of various materials for protecting a Dressing Dosage Form
wound.
C17423 DRUG DELIVERY SYSTEM Modern technology, distributed with or as a part of a drug Drug Delivery System
product that allows for the uniform release or targeting of
drugs to the body.
C42912 ELIXIR A clear, pleasantly flavored, sweetened hydroalcoholic Elixir Dosage Form
liquid containing dissolved medicinal agents; it is
intended for oral use. (NCI)
C42913 EMULSION A dosage form consisting of a two-phase system Emulsion Dosage Form
comprised of at least two immiscible liquids (1), one of
which is dispersed as droplets (internal or dispersed
phase) within the other liquid (external or continuous
phase), generally stabilized with one or more emulsifying
agents. Note 1: A liquid is pourable; it flows and
conforms to its container at room temperature. It
displays Newtonian or pseudoplastic flow behavior. Note
2: Emulsion is used as a dosage form term unless a more
specific term is applicable, e.g. cream, lotion, ointment.
(NCI)
C42915 ENEMA A rectal preparation for therapeutic, diagnostic, or Enema Dosage Form
nutritive purposes. (NCI)
C42929 EXTRACT A concentrated preparation of vegetable or animal drugs Extract Dosage Form
obtained by removal of the active constituents of the
respective drugs with a suitable menstrua, evaporation of
all or nearly all of the solvent, and adjustment of the
residual masses or powders to the prescribed standards.
(NCI)
C60926 FIBER, EXTENDED A slender and elongated solid thread-like substance that Extended Release Fiber
RELEASE delivers drug in such a manner to allow a reduction in Dosage Form
dosing frequency as compared to that drug (or drugs)
presented as a conventional dosage form.
C42932 FILM A thin layer or coating. (NCI) Film Dosage Form
C42920 FILM, EXTENDED A drug delivery system in the form of a film that releases Extended Release Film
RELEASE the drug over an extended period in such a way as to Dosage Form
maintain constant drug levels in the blood or target
tissue. (NCI)
C42984 FILM, SOLUBLE A thin layer or coating which is susceptible to being Soluble Film Dosage Form
dissolved when in contact with a liquid. (NCI)
C60927 FOR SOLUTION A product, usually a solid, intended for solution prior to Dosage Form for Solution
administration.
C60928 FOR SUSPENSION A product, usually a solid, intended for suspension prior Dosage Form for
to administration. Suspension
C60929 FOR SUSPENSION, A product, usually a solid, intended for suspension prior Extended Release Dosage
EXTENDED RELEASE to administration; once the suspension is administered, Form for Suspension
the drug will be released at a constant rate over a
specified period.
C42933 GAS Any elastic aeriform fluid in which the molecules are Gas Dosage Form
separated from one another and have free paths. (NCI)
C42934 GEL A semisolid (1) dosage form that contains a gelling agent Gel Dosage Form
to provide stiffness to a solution or a colloidal dispersion
(2). A gel may contain suspended particles. Note 1: A
semisolid is not pourable; it does not flow or conform to
its container at room temperature. It does not flow at low
shear stress and generally exhibits plastic flow behavior.
Note 2: A colloidal dispersion is a system in which
particles of colloidal dimension (i.e., typically between 1
nm and 1 micrometer) are distributed uniformly
throughout a liquid.
page 629 of 1925

C66726 FRM
Code Value
C42906 GEL, DENTIFRICE A combination of a dentifrice (formulation intended to Dentifrice Gel Dosage
clean and/or polish the teeth, and which may contain Form
certain additional agents), and a gel. It is used with a
toothbrush for the purpose of cleaning and polishing the
teeth. (NCI)
C60930 GEL, METERED A gel preparation, with metered dose valves, which allow Metered Gel Dosage Form
for the delivery of a uniform quantity of gel upon each
activation.
C48193 GENERATOR An apparatus for the formation of vapor or gas from a Generator Dosage Form
liquid or solid by heat or chemical action. The term
GENERATOR also applies to radioactive columns from
which radionuclides are provided. (NCI)
C42937 GLOBULE Also called pellets or pilules, are made of pure sucrose, Globule Dosage Form
lactose, or other polysaccharides. They are formed into
small globular masses of various sizes, and are medicated
by placing them in a vial and adding the liquid drug
attenuation in the proportion not less than one percent
(v/w). After shaking, the medicated globules are dried at
temperatures not to exceed 40 degrees Centigrade. (NCI)
C45416 GRAFT A slip of skin or of other tissue for implantation. (NCI) Graft Dosage Form
C42938 GRANULE A small particle or grain. (NCI) Granule Dosage Form
C42903 GRANULE, DELAYED A small medicinal particle or grain to which an enteric or Delayed Release Granule
RELEASE other coating has been applied, thus delaying release of Dosage Form
the drug until its passage into the intestines. (NCI)
C42909 GRANULE, A small particle or grain containing a medicinal agent in a Effervescent Granule
EFFERVESCENT dry mixture usually composed of sodium bicarbonate, Dosage Form
citric acid, and tartaric acid which, when in contact with
water, has the capability to release gas, resulting in
effervescence. (NCI)
C42939 GRANULE, FOR A small medicinal particle or grain made available in its Granule for Solution
SOLUTION more stable dry form, to be reconstituted with solvent Dosage Form
just before dispensing; the granules are so prepared to
contain not only the medicinal agent, but the colorants,
flavorants, and any other desired pharmaceutic
ingredient. (NCI)
C42940 GRANULE, FOR A small medicinal particle or grain made available in its Granule for Suspension
SUSPENSION more stable dry form, to be reconstituted with solvent Dosage Form
just before dispensing to form a suspension; the granules
are so prepared to contain not only the medicinal agent,
but the colorants, flavorants, and any other desired
pharmaceutic ingredient. (NCI)
C42921 GRANULE, FOR A small medicinal particle or grain made available in its Extended Release
SUSPENSION, EXTENDED more stable dry form, to be reconstituted with solvent Granule for Suspension
RELEASE just before dispensing to form a suspension; the Dosage Form
extended release system achieves slow release of the
drug over an extended period of time and maintains
constant drug levels in the blood or target tissue. (NCI)
C42941 GUM A mucilaginous excretion from various plants. (NCI) Gum Dosage Form
C42894 GUM, CHEWING A sweetened and flavored insoluble plastic material of Chewing Gum Dosage
various shapes which when chewed, releases a drug Form
substance into the oral cavity. (NCI)
C42978 GUM, RESIN Natural mixture of gum and resin, usually obtained as Resin Gum Dosage Form
exudations from plants. (NCI)
C42942 IMPLANT A material containing drug intended to be inserted Implant Dosage Form
securely and deeply in a living site for growth, slow
release, or formation of an organic union. (NCI)
C42944 INHALANT A special class of inhalations consisting of a drug or Inhalant Dosage Form
combination of drugs, that by virtue of their high vapor
pressure, can be carried by an air current into the nasal
passage where they exert their effect; the container from
which the inhalant generally is administered is known as
an inhaler. (NCI)
C60931 INJECTABLE, LIPOSOMAL An injection, which either consists of or forms liposomes Liposomal Injection
(a lipid bilayer vesicle usually composed of phospholipids Dosage Form
which is used to encapsulate an active drug substance).
page 630 of 1925

C66726 FRM
Code Value
C42946 INJECTION A sterile preparation intended for parenteral use; five Injectable Dosage Form
distinct classes of injections exist as defined by the USP.
(NCI)
C42914 INJECTION, EMULSION An emulsion consisting of a sterile, pyrogen-free Emulsion for Injection
preparation intended to be administered parenterally. Dosage Form
C42950 INJECTION, LIPID A substance composed of complexed active and/or inert Injectable Lipid Complex
COMPLEX ingredient(s) with natural or synthetic lipids that is Dosage Form
intended for injection. (NCI)
C42974 INJECTION, POWDER, A sterile preparation intended for reconstitution to form a Powder for Injectable
FOR SOLUTION solution for parenteral use. (NCI) Solution Dosage Form
C42976 INJECTION, POWDER, A sterile preparation intended for reconstitution to form a Powder for Injectable
FOR SUSPENSION suspension for parenteral use. (NCI) Suspension Dosage Form
C42977 INJECTION, POWDER, A dried preparation intended for reconstitution to form a Powder for Injectable
FOR SUSPENSION, suspension for parenteral use which has been formulated Extended Release
EXTENDED RELEASE in a manner to allow at least a reduction in dosing Suspension Dosage Form
frequency as compared to that drug presented as a
conventional dosage form (e.g., as a solution).
C42959 INJECTION, POWDER, A sterile freeze dried preparation intended for Lyophilized Powder for
LYOPHILIZED, FOR reconstitution for parenteral use which has been Injectable Liposomal
LIPOSOMAL SUSPENSION formulated in a manner that would allow liposomes (a Suspension Dosage Form
lipid bilayer vesicle usually composed of phospholipids
which is used to encapsulate an active drug substance,
either within a lipid bilayer or in an aqueous space) to be
formed upon reconstitution. (NCI)
C42957 INJECTION, POWDER, A dosage form intended for the solution prepared by Lyophilized Powder for
LYOPHILIZED, FOR lyophilization ('freeze drying'), a process which involves Injectable Solution
SOLUTION the removal of water from products in the frozen state at Dosage Form
extremely low pressures; this is intended for subsequent
addition of liquid to create a solution that conforms in all
respects to the requirements for Injections. (NCI)
C42958 INJECTION, POWDER, A liquid preparation, intended for parenteral use, that Lyophilized Powder for
LYOPHILIZED, FOR contains solids suspended in a suitable fluid medium and Injectable Suspension
SUSPENSION conforms in all respects to the requirements for Sterile Dosage Form
Suspensions; the medicinal agents intended for the
suspension are prepared by lyophilization ("freeze
drying"), a process which involves the removal of water
from products in the frozen state at extremely low
pressures.
C42956 INJECTION, POWDER, A sterile freeze dried preparation intended for Lyophilized Powder for
LYOPHILIZED, FOR reconstitution for parenteral use which has been Extended Release
SUSPENSION, EXTENDED formulated in a manner to allow at least a reduction in Injectable Suspension
RELEASE dosing frequency as compared to that drug presented as Dosage Form
a conventional dosage form (e.g., as a solution). (NCI)
C42945 INJECTION, SOLUTION A liquid preparation containing one or more drug Injectable Solution
substances dissolved in a suitable solvent or mixture of Dosage Form
mutually miscible solvents that is suitable for injection.
(NCI)
C42899 INJECTION, SOLUTION, A sterile preparation for parenteral use which, upon the Concentrated Injectable
CONCENTRATE addition of suitable solvents, yields a solution conforming Solution Dosage Form
in all respects to the requirements for Injections. (NCI)
C42995 INJECTION, SUSPENSION A liquid preparation, suitable for injection, which consists Injectable Suspension
of solid particles dispersed throughout a liquid phase in Dosage Form
which the particles are not soluble. It can also consist of
an oil phase dispersed throughout an aqueous phase, or
vice-versa. (NCI)
C42926 INJECTION, A sterile preparation intended for parenteral use which Injectable Extended
SUSPENSION, EXTENDED has been formulated in a manner to allow at least a Release Suspension
RELEASE reduction in dosing frequency as compared to that drug Dosage Form
presented as a conventional dosage form (e.g., as a
solution or a prompt drug-releasing, conventional solid
dosage form). (NCI)
page 631 of 1925

C66726 FRM
Code Value
C42951 INJECTION, A liquid parenteral pharmaceutical dosage form Injectable Liposomal

SUSPENSION, structured as a multilamellar composition of concentric Suspension Dosage Form
LIPOSOMAL phospholipid spheres that encapsulate the drug (drug
delivery systems) separated by layers of water. Drug
release is facilitated and controlled by in vivo erosion of
the liposomes. To further increase the in vivo circulation
time, liposomes in some preparations are covalently
derivatized with PEG to produce PEGylated or stealth
liposomes. Covalent attachment of drugs to the outer
surface of liposomes can potentially serve as a delayed-
release product. (NCI)
C42988 INJECTION, A liquid preparation, suitable for injection, which consists Injectable Sonicated
SUSPENSION, of solid particles dispersed throughout a liquid phase in Suspension Dosage Form
SONICATED which the particles are not soluble. In addition, the
product is sonicated while a gas is bubbled through the
suspension, and this results in the formation of
microspheres by the solid particles. (NCI)
C60933 INSERT A specially formulated and shaped non-encapsulated solid Insert Dosage Form
preparation intended to be placed into a non-rectal orifice
of the body, where drug is released, generally for
localized effects.
C42922 INSERT, EXTENDED A specially formulated and shaped solid preparation (e.g., Extended Release Insert
RELEASE ring, tablet, or stick) intended to be placed in the vagina Dosage Form
by special inserters, where the medication is released,
generally for localized effects; the extended release
preparation is designed to allow a reduction in dosing
frequency. (NCI)
C47915 INTRAUTERINE DEVICE A device inserted and left in the uterus to prevent Intrauterine Device
effective conception. (NCI) Dosage Form
C42947 IRRIGANT A sterile solution intended to bathe or flush open wounds Irrigant Dosage Form
or body cavities; they're used topically, never
parenterally. (NCI)
C42948 JELLY A class of gels--semisolid systems which consist of Jelly Dosage Form
suspensions made up of either small inorganic particles or
large organic molecules interpenetrated by a liquid--in
which the structural coherent matrix contains a high
portion of liquid, usually water. (NCI)
C47916 KIT A packaged collection of related material. (NCI) Kit Dosage Form
C45413 LINER, DENTAL A material applied to the inside of the dental cavity, for Dental Liner Dosage Form
protection or insulation of the surface.
C42949 LINIMENT A solution or mixture of various substances in oil, Liniment Dosage Form
alcoholic solutions of soap, or emulsions intended for
external application. (NCI)
C42952 LIPSTICK A waxy solid, usually colored cosmetic, in stick form for Lipstick Dosage Form
the lips. (NCI)
C42953 LIQUID A dosage form consisting of a pure chemical in its liquid Liquid Dosage Form
state. This dosage form term should not be applied to
solutions. Note: A liquid is pourable; it flows and
conforms to its container at room temperature. It
displays Newtonian or pseudoplastic flow behavior.
C60934 LIQUID, EXTENDED A liquid that delivers a drug in such a manner to allow a Extended Release Liquid
RELEASE reduction in dosing frequency as compared to that drug Dosage Form
(or drugs) presented as a conventional dosage form.
C29167 LOTION An emulsion, liquid (1) dosage form. This dosage form is Lotion Dosage Form
generally for external application to the skin (2). Note 1:
A liquid is pourable; it flows and conforms to its container
at room temperature. It displays Newtonian or
pseudoplastic flow behavior. Note 2: Previously the
definition of a lotion was: The term lotion has been used
to categorize many topical suspensions, solutions, and
emulsions intended for application to the skin. The
current definition of a lotion is restricted to an emulsion.
C60957 LOTION, AUGMENTED A lotion dosage form that enhances drug delivery. Augmented Lotion
page 632 of 1925

C66726 FRM
Code Value
C60958 LOTION/SHAMPOO A lotion dosage form which has a soap or detergent that Lotion Shampoo Dosage
is usually used to clean the hair and scalp; it is often used Form
as a vehicle for dermatologic agents.
C42955 LOZENGE A solid preparation containing one or more medicaments, Lozenge Dosage Form
usually in a flavored, sweetened base which is intended
to dissolve or disintegrate slowly in the mouth. A lollipop
is a lozenge on a stick.
C29269 MOUTHWASH An aqueous solution which is most often used for its Mouthwash Dosage Form
deodorant, refreshing, or antiseptic effect. (NCI)
C48624 NOT APPLICABLE The use of a dosage form term is not relevant or Dosage Form Not
appropriate. (NCI) Applicable
C42965 OIL An unctuous, combustible substance which is liquid, or Oil Dosage Form
easily liquefiable, on warming, and is soluble in ether but
insoluble in water. Such substances, depending on their
origin, are classified as animal, mineral, or vegetable oils.
(NCI)
C42966 OINTMENT oint A suspension or emulsion, semisolid (1) dosage form, Ointment Dosage Form
usually containing less than 20 percent water and
volatiles (2) and greater than 50 percent hydrocarbons,
waxes, or polyols as the vehicle. This dosage form is
generally for external application to the skin or mucous
membranes. Note 1: A semisolid is not pourable; it does
not flow or conform to its container at room temperature.
It does not flow at low shear stress and generally exhibits
plastic flow behavior. Note 2: Percent water and volatiles
are measured by a loss on drying test in which the
sample is heated at 105 degrees C until constant weight
is achieved.
C60984 OINTMENT, AUGMENTED An ointment dosage form that enhances drug delivery. Augmented Ointment
C47887 PACKING A material, usually covered by or impregnated with a Packing Dosage Form
drug, that is inserted into a body cavity or between the
tooth enamel and the gingival margin.
C42967 PASTE A semisolid dosage form, containing a large proportion Paste Dosage Form
(20 - 50%) of solids finely dispersed in a fatty vehicle.
This dosage form is generally for external application to
the skin or mucous membranes. Note: A semisolid is not
pourable; it does not flow or conform to its container at
room temperature. It does not flow at low shear stress
and generally exhibits plastic flow behavior. (NCI)
C42907 PASTE, DENTIFRICE A paste formulation intended to clean and/or polish the Dentifrice Paste Dosage
teeth, and which may contain certain additional agents. Form
(NCI)
C60985 PASTILLE An aromatic preparation, often with a pleasing flavor, Pastille Dosage Form
usually intended to dissolve in the mouth.
C42968 PATCH A drug delivery system that often contains an adhesive Patch Dosage Form
backing that is usually applied to an external site on the
body. Its ingredients either passively diffuse from, or are
actively transported from, some portion of the patch.
Depending upon the patch, the ingredients are either
delivered to the outer surface of the body or into the
body. A patch is sometimes synonymous with the terms
Extended Release Film and System.
C42923 PATCH, EXTENDED A drug delivery system in the form of a patch that Extended Release Patch
RELEASE releases the drug in such a manner that a reduction in Dosage Form
dosing frequency compared to that drug presented as a
conventional dosage form (e.g., a solution or a prompt
drug-releasing, conventional solid dosage form). (NCI)
C42911 PATCH, EXTENDED A drug delivery system in the form of a patch which is Electrically Controlled
RELEASE, ELECTRICALLY controlled by an electric current that releases the drug in Extended Release Patch
CONTROLLED such a manner that a reduction in dosing frequency Dosage Form
dosage form (e.g., a solution or a prompt drug-releasing,
conventional solid dosage form). (NCI)
C42969 PELLET A small sterile solid mass consisting of a highly purified Pellet Dosage Form
drug (with or without excipients) made by the formation
of granules, or by compression and molding. (NCI)
page 633 of 1925

C66726 FRM
Code Value
C42943 PELLET, IMPLANTABLE A small sterile solid mass consisting of a highly purified Implantable Pellet Dosage
drug (with or without excipients) made by the formation Form
of granules, or by compression and molding; they are
intended for implantation in the body (usually
subcutaneously) for the purpose of providing continuous
release of the drug over long periods of time.
C42918 PELLETS, COATED, A solid dosage form in which the drug itself is in the form Extended Release Coated
EXTENDED RELEASE of granules to which varying amounts of coating have Pellet Dosage Form
been applied, and which releases a drug (or drugs) in
such a manner to allow a reduction in dosing frequency
as compared to that drug (or drugs) presented as a
conventional dosage form. (NCI)
C25394 PILL A dose of medicine in the form of a small pellet. (NCI) Pill Dosage Form
C42970 PLASTER Substance intended for external application made of such Plaster Dosage Form
materials and of such consistency as to adhere to the skin
and attach to a dressing; plasters are intended to afford
protection and support and/or to furnish an occlusion and
macerating action and to bring medication into close
contact with the skin.
C47913 POULTICE A soft, moist mass of meal, herbs, seed, etc., usually Poultice Dosage Form
applied hot in cloth that consists of gruel-like consistency.
(NCI)
C42972 POWDER An intimate mixture of dry, finely divided drugs and/or Powder Dosage Form
chemicals that may be intended for internal or external
use. (NCI)
C42908 POWDER, DENTIFRICE A powder formulation intended to clean and/or polish the Dentifrice Powder Dosage
teeth, and which may contain certain additional agents. Form
(NCI)
C42973 POWDER, FOR SOLUTION An intimate mixture of dry, finely divided drugs and/or Powder for Solution
chemicals, which, upon the addition of suitable vehicles, Dosage Form
yields a solution. (NCI)
C42975 POWDER, FOR An intimate mixture of dry, finely divided drugs and/or Powder for Suspension
SUSPENSION chemicals, which, upon the addition of suitable vehicles, Dosage Form
yields a suspension (a liquid preparation containing the
solid particles dispersed in the liquid vehicle). (NCI)
C42961 POWDER, METERED A powder dosage form that is situated inside a container Metered Powder Dosage
that has a mechanism to deliver a specified quantity. Form
(NCI)
C60988 RING A small circular object with a vacant circular center that is Ring Dosage Form
usually intended to be placed in the body by special
inserters, where the medication is released, generally for
localized effects.
C42979 RINSE A liquid used to cleanse by flushing. (NCI) Rinse Dosage Form
C42980 SALVE A thick ointment or cerate (a fat or wax based Salve Dosage Form
preparation with a consistency between an ointment and
a plaster). (NCI)
C42981 SHAMPOO A liquid soap or detergent used to clean the hair and Shampoo Dosage Form
scalp and is often used as a vehicle for dermatologic
agents. (NCI)
C42982 SHAMPOO, SUSPENSION A liquid soap or detergent containing one or more solid, Shampoo Suspension
insoluble substances dispersed in a liquid vehicle that is Dosage Form
used to clean the hair and scalp and is often used as a
vehicle for dermatologic agents. (NCI)
C42983 SOAP Any compound of one or more fatty acids, or their Soap Dosage Form
equivalents, with an alkali; soap is detergent and is much
employed in liniments, enemas, and in making pills. It is
also a mild aperient, antacid and antiseptic. (NCI)
C42986 SOLUTION A clear, homogeneous liquid dosage form that contains Solution Dosage Form
one or more chemical substances dissolved in a solvent or
mixture of mutually miscible solvents. Note: A liquid is
pourable; it flows and conforms to its container at room
temperature. It displays Newtonian or pseudoplastic flow
behavior.
page 634 of 1925

C66726 FRM
Code Value
C42898 SOLUTION, A liquid preparation (i.e., a substance that flows readily in Concentrated Solution
CONCENTRATE its natural state) that contains a drug dissolved in a Dosage Form
suitable solvent or mixture of mutually miscible solvents;
the drug has been strengthened by the evaporation of its
non-active parts. (NCI)
C42987 SOLUTION, FOR SLUSH A solution for the preparation of an iced saline slush, Solution for Slush Dosage
which is administered by irrigation and used to induce Form
regional hypothermia (in conditions such as certain open
heart and kidney surgical procedures) by its direct
application. (NCI)
C60994 SOLUTION, GEL A solution, which after usually being administered in a Gel Forming Drop
FORMING / DROPS drop-wise fashion, forms a gel. Solution Dosage Form
C42935 SOLUTION, GEL A solution that forms a gel when it comes in contact with Extended Release Gel
FORMING, EXTENDED ocular fluid, and which allows at least a reduction in Forming Solution Dosage
RELEASE dosing frequency. Form
C60992 SOLUTION/ DROPS A solution which is usually administered in a drop-wise Drop Solution Dosage
fashion. Form
C47912 SPONGE A porous, interlacing, absorbent material that contains a Sponge Dosage Form
drug. It is typically used for applying or introducing
medication, or for cleansing. A sponge usually retains its
shape.
C42989 SPRAY A liquid minutely divided as by a jet of air or steam. (NCI) Spray Dosage Form
C42962 SPRAY, METERED A non-pressurized dosage form consisting of valves which Metered Spray Dosage
allow the dispensing of a specified quantity of spray upon Form
each activation. (NCI)
C42990 SPRAY, SUSPENSION A liquid preparation containing solid particles dispersed in Spray Suspension Dosage
a liquid vehicle and in the form of coarse droplets or as Form
finely divided solids to be applied locally, most usually to
the nasal-pharyngeal tract, or topically to the skin. (NCI)
C42991 STICK A dosage form prepared in a relatively long and slender Stick Dosage Form
often cylindrical form. (NCI)
C47914 STRIP A long narrow piece of material. Strip Dosage Form
C42993 SUPPOSITORY supp A solid body of various weights and shapes, adapted for Suppository Dosage Form
introduction into the rectal, vaginal, or urethral orifice of
the human body; they usually melt, soften, or dissolve at
body temperature.
C42924 SUPPOSITORY, A drug delivery system in the form of a suppository that Extended Release
EXTENDED RELEASE allows at least a reduction in dosing frequency. (NCI) Suppository Dosage Form
C42994 SUSPENSION susp A liquid dosage form that contains solid particles Suspension Dosage Form
dispersed in a liquid vehicle. Note: A liquid is pourable; it
flows and conforms to its container at room temperature.
It displays Newtonian or pseudoplastic flow behavior.
C42925 SUSPENSION, EXTENDED A liquid preparation consisting of solid particles dispersed Extended Release
RELEASE throughout a liquid phase in which the particles are not Suspension Dosage Form
soluble; the suspension has been formulated in a manner
to allow at least a reduction in dosing frequency as
dosage form (e.g., as a solution or a prompt drug-
releasing, conventional solid dosage form). (NCI)
C60995 SUSPENSION/DROPS A suspension which is usually administered in a dropwise Drop Suspension Dosage
fashion. Form
C47889 SUTURE A strand or fiber used to hold wound edges in apposition Suture Dosage Form
during healing. (NCI)
C47898 SWAB A small piece of relatively flat absorbent material that Swab Dosage Form
contains a drug. A swab may also be attached to one end
of a small stick. A swab is typically used for applying
medication or for cleansing.
C42996 SYRUP An oral solution containing high concentrations of sucrose Syrup Dosage Form
or other sugars; the term has also been used to include
any other liquid dosage form prepared in a sweet and
viscid vehicle, including oral suspensions. (NCI)
C42998 TABLET tab A solid dosage form containing medicinal substances with Tablet Dosage Form
or without suitable diluents. (NCI)
page 635 of 1925

C66726 FRM
Code Value
C42893 TABLET, CHEWABLE A solid dosage form containing medicinal substances with Chewable Tablet Dosage
or without suitable diluents that is intended to be chewed, Form
producing a pleasant tasting residue in the oral cavity
that is easily swallowed and does not leave a bitter or
unpleasant after-taste. (NCI)
C42897 TABLET, COATED A solid dosage form that contains medicinal substances Coated Tablet Dosage
with or without suitable diluents and is covered with a Form
designated coating. (NCI)
C60997 TABLET, COATED A solid dosage form containing a conglomerate of Tablet Coated Particle
PARTICLES medicinal particles that have each been covered with a Dosage Form
coating.
C42905 TABLET, DELAYED A solid dosage form which releases a drug (or drugs) at a Delayed Release Tablet
RELEASE time other than promptly after administration. Enteric- Dosage Form
coated articles are delayed release dosage forms. (NCI)
C42997 TABLET, DELAYED A solid dosage form containing a conglomerate of Delayed Release Particle
RELEASE PARTICLES medicinal particles that have been covered with a coating Tablet Dosage Form
which releases a drug (or drugs) at a time other than
promptly after administration. Enteric-coated articles are
delayed release dosage forms. (NCI)
C42910 TABLET, EFFERVESCENT A solid dosage form containing mixtures of acids (e.g., Effervescent Tablet
citric acid, tartaric acid) and sodium bicarbonate, which Dosage Form
release carbon dioxide when dissolved in water; it is
intended to be dissolved or dispersed in water before
administration.
C42927 TABLET, EXTENDED A solid dosage form containing a drug which allows at Extended Release Tablet
RELEASE least a reduction in dosing frequency as compared to that Dosage Form
drug presented in conventional dosage form. (NCI)
C42931 TABLET, FILM COATED A solid dosage form that contains medicinal substances Film Coated Tablet
with or without suitable diluents and is coated with a thin Dosage Form
layer of a water-insoluble or water-soluble polymer. (NCI)
C42930 TABLET, FILM COATED, A solid dosage form that contains medicinal substances Film Coated Extended
EXTENDED RELEASE with or without suitable diluents and is coated with a thin Release Tablet Dosage
layer of a water-insoluble or water-soluble polymer; the Form
tablet is formulated in such manner as to make the
contained medicament available over an extended period
of time following ingestion.
C61004 TABLET, FOR SOLUTION A tablet that forms a solution when placed in a liquid. Tablet for Solution
Dosage Form
C61005 TABLET, FOR A tablet that forms a suspension when placed in a liquid Tablet for Suspension
SUSPENSION (formerly referred to as a Dispersible Tablet). Dosage Form
C142248 TABLET, IMMEDIATE A solid dosage form containing medicinal substances with Immediate Release Tablet
RELEASE or without suitable diluents, which is designed to release Dosage Form
its active and/or inert ingredient(s) immediately upon
administration.
C42964 TABLET, MULTILAYER A solid dosage form containing medicinal substances that Multilayered Tablet
have been compressed to form a multiple-layered tablet Dosage Form
or a tablet-within-a-tablet, the inner tablet being the core
and the outer portion being the shell. (NCI)
C42963 TABLET, MULTILAYER, A solid dosage form containing medicinal substances that Multilayered Extended
EXTENDED RELEASE have been compressed to form a multiple-layered tablet Release Tablet Dosage
or a tablet-within-a-tablet, the inner tablet being the core Form
and the outer portion being the shell, which, additionally,
is covered in a designated coating; the tablet is
formulated in such manner as to allow at least a
reduction in dosing frequency as compared to that drug
presented as a conventional dosage form. (NCI)
C42999 TABLET, ORALLY A solid dosage form containing medicinal substances Orally Disintegrating
DISINTEGRATING which disintegrates rapidly, usually within a matter of Tablet Dosage Form
seconds, when placed upon the tongue. (NCI)
C61006 TABLET, ORALLY A solid dosage form containing medicinal substances Orally Disintegrating
DISINTEGRATING, which disintegrates rapidly, usually within a matter of Delayed Release Tablet
DELAYED RELEASE seconds, when placed upon the tongue, but which Dosage Form
releases a drug (or drugs) at a time other than promptly
after administration.
C42985 TABLET, SOLUBLE A solid dosage form that contains medicinal substances Soluble Tablet Dosage
with or without suitable diluents and possesses the ability Form
to dissolve in fluids. (NCI)
page 636 of 1925

C66726 FRM
Code Value
C42992 TABLET, SUGAR COATED A solid dosage form that contains medicinal substances Sugar Coated Tablet
with or without suitable diluents and is coated with a Dosage Form
colored or an uncolored water-soluble sugar. (NCI)
C47892 TAMPON A plug made of cotton, sponge, or oakum variously used Tampon Dosage Form
in surgery to plug the nose, vagina, etc., for the control
of hemorrhage or the absorption of secretions. (NCI)
C47897 TAPE A narrow woven fabric, or a narrow extruded synthetic Tape Dosage Form
(such as plastic), usually with an adhesive on one or both
sides. (NCI)
C43000 TINCTURE An alcoholic or hydroalcoholic solution prepared from Tincture Dosage Form
vegetable materials or from chemical substances. (NCI)
C43001 TROCHE A discoid-shaped solid containing the medicinal agent in a Troche Dosage Form
suitably flavored base; troches are placed in the mouth
where they slowly dissolve, liberating the active
ingredients. (NCI)
C43002 UNASSIGNED A dosage form has yet to be assigned. (NCI) Unassigned Dosage Form
C43003 WAFER A thin slice of material containing a medicinal agent. Wafer Dosage Form
(NCI)
page 637 of 1925

FSS01TC (Fatigue Severity Scale Questionnaire Test Code)
C113850 FSS01TC
Code Value
C113944 FSS0101 FSS01-Motivation Is Fatigue Severity Scale - My motivation is lower when I FSS - Motivation is Lower
Lower When Fatigued am fatigued. When Fatigued
C113945 FSS0102 FSS01-Exercise Brings on Fatigue Severity Scale - Exercise brings on my fatigue. FSS - Exercise Brings on
My Fatigue My Fatigue
C113946 FSS0103 FSS01-I Am Easily Fatigue Severity Scale - I am easily fatigued. FSS - I Am Easily
Fatigued Fatigued
C113947 FSS0104 FSS01-Interferes With Fatigue Severity Scale - Fatigue interferes with my FSS - Fatigue Interferes
Phys Function physical functioning. With Physical Functioning
C113948 FSS0105 FSS01-Fatigue Causes Fatigue Severity Scale - Fatigue causes frequent FSS - Fatigue Causes
Frequent Problems problems for me. Frequent Problems
C113949 FSS0106 FSS01-Prevents Fatigue Severity Scale - My fatigue prevents sustained FSS - Fatigue Prevents
Sustained Phys Function physical functioning. Sustained Physical
Functioning
C113950 FSS0107 FSS01-Fatigue Interferes Fatigue Severity Scale - Fatigue interferes with carrying FSS - Fatigue Interferes
With Duties out certain duties and responsibilities. With Carrying Out Duties
C113951 FSS0108 FSS01-Among My 3 Most Fatigue Severity Scale - Fatigue is among my three most FSS - Fatigue is Among
Disabling Symptoms disabling symptoms. Most Disabling Symptoms
C113952 FSS0109 FSS01-Fatigue Interferes Fatigue Severity Scale - Fatigue interferes with my work, FSS - Fatigue Interferes
With My Life family, or social life. With Work
page 638 of 1925

FSS01TN (Fatigue Severity Scale Questionnaire Test Name)
C113849 FSS01TN
Code Value
C113951 FSS01-Among My 3 Most FSS01-Among My 3 Most Fatigue Severity Scale - Fatigue is among my three most FSS - Fatigue is Among
Disabling Symptoms Disabling Symptoms disabling symptoms. Most Disabling Symptoms
C113945 FSS01-Exercise Brings on FSS01-Exercise Brings on Fatigue Severity Scale - Exercise brings on my fatigue. FSS - Exercise Brings on
My Fatigue My Fatigue My Fatigue
C113948 FSS01-Fatigue Causes FSS01-Fatigue Causes Fatigue Severity Scale - Fatigue causes frequent FSS - Fatigue Causes
Frequent Problems Frequent Problems problems for me. Frequent Problems
C113950 FSS01-Fatigue Interferes FSS01-Fatigue Interferes Fatigue Severity Scale - Fatigue interferes with carrying FSS - Fatigue Interferes
With Duties With Duties out certain duties and responsibilities. With Carrying Out Duties
C113952 FSS01-Fatigue Interferes FSS01-Fatigue Interferes Fatigue Severity Scale - Fatigue interferes with my work, FSS - Fatigue Interferes
With My Life With My Life family, or social life. With Work
C113946 FSS01-I Am Easily FSS01-I Am Easily Fatigue Severity Scale - I am easily fatigued. FSS - I Am Easily
Fatigued Fatigued Fatigued
C113947 FSS01-Interferes With FSS01-Interferes With Fatigue Severity Scale - Fatigue interferes with my FSS - Fatigue Interferes
Phys Function Phys Function physical functioning. With Physical Functioning
C113944 FSS01-Motivation Is FSS01-Motivation Is Fatigue Severity Scale - My motivation is lower when I FSS - Motivation is Lower
Lower When Fatigued Lower When Fatigued am fatigued. When Fatigued
C113949 FSS01-Prevents FSS01-Prevents Fatigue Severity Scale - My fatigue prevents sustained FSS - Fatigue Prevents
Sustained Phys Function Sustained Phys Function physical functioning. Sustained Physical
Functioning
page 639 of 1925

FTCAT (Category of Functional Test)
C115304 FTCAT
Code Value
C141689 4 STAIR ASCEND A4STR1 4 Stair Ascend (Mcdonald, C. M., Henricson, E. K., Four Stair Ascend Test
Abresch, R. T., Florence, J. M., Eagle, M., Gappmaier, E., Functional Test
et al. (2013). THE 6-MINUTE WALK TEST AND OTHER
ENDPOINTS IN DUCHENNE MUSCULAR DYSTROPHY:
LONGITUDINAL NATURAL HISTORY OBSERVATIONS
OVER 48 WEEKS FROM A MULTICENTER STUDY. Muscle &
Nerve, 48(3), 343-356.
http://doi.org/10.1002/mus.23902).
C141688 4 STAIR DESCEND D4STR1 Descend 4 Stairs (Mcdonald, C. M., Henricson, E. K., Four Stair Descend Test
Nerve, 48(3), 343-356.
http://doi.org/10.1002/mus.23902).
C102112 AVLT AVL01 The Alzheimer's Disease Neuroimaging Initiative's (ADNI) Alzheimer's Disease
version of the Auditory Verbal Learning Test (AVLT Neuroimaging Initiative
Version A) modified from Rey A. L'examen clinique en Auditory Verbal Learning
psychologie [Clinical tests in psychology]. Paris: Presses Test Functional Test
Universitaires de France; 1964.
C123668 AVLT-REY AVL02 Auditory Verbal Learning Test (AVLT-Rey) (Modified from Rey Auditory Verbal
Rey A. L'examen clinique en psychologie [Clinical tests in Learning Functional Test
psychology]. Paris: Presses Universitaires de France;
1964. Test-Retest Reliability of a New Form of Auditory
Verbal Learning Test (AVLT); Archives of Clinical
Neuropsycology, Vol. 9, No. 4, pp. 303-316, 1994.
Performance of Healthy Subjects and Patients with
Resection from the Anterior Temporal Lobe on Matched
Tests of Verbal and Visuoperceptual Learning; Journal of
Clinical and Experimental Neuropsychology 1996, Vol. 18,
No. 3, pp. 416-430).
C121004 BACS BACS1 Brief Assessment of Cognition in Schizophrenia (BACS) Brief Assessment of
(Richard Keefe, PhD, Copyright 1999 Duke University Cognition in
Medical Center, Licenses available through Neurocog Schizophrenia Functional
Trials, Inc.). Test
C114144 COWAT COWAT1 Controlled Oral Word Association Test (COWAT) (Benton, Controlled Oral Word
A.L., Hamsher, K., & Sivan, A.B. (1994). Multilingual Association Test
Aphasia Examination (3rd ed.). Iowa City, IA: AJA
Associates).
C150909 EMOTION RECOGNITION EMO1 Emotion Recognition (Ekman P, Friesen WV. Measuring Emotion Recognition Test
facial movement. Environmental Psychology and Functional Test
Nonverbal Behavior. 1976;1(1):56-75).
C115790 HAUSER AMBULATION HAI01 Hauser Ambulation Index (AI) (Hauser SL, Dawson DM, Hauser Ambulation Index
INDEX Lehrich JR, Beal MF, Kevy SV, Propper RD, Mills JA, Functional Test
Weiner HL. Intensive immunosuppression in progressive
multiple sclerosis. A randomized, three-arm study of
high-dose intravenous cyclophosphamide, plasma
exchange, and ACTH. N Engl J Med. 1983 Jan
27;308(4):173-80).
C74982 MMSE MMS1 Mini-Mental State Examination (MMSE) (MMSE Copyright Mini-Mental Status Exam
1975, 1998, 2001 by MiniMental, LLC All rights reserved.
Published 2001 by Psychological Assessment Resources,
Inc. May not be reproduced in whole or in part in any
form or by any means without written permission of
Psychological Assessment Resources, Inc.).
C150910 MMSE-2 STANDARD MMS2 Mini-Mental State Examination 2 Standard Version Mini-Mental State
VERSION (MMSE-2 Standard Version) (MMSE Copyright 1975, Examination 2 Standard
1998, 2001 and MMSE-2 Copyright 2010 by MiniMental, Version Functional Test
LLC. All rights reserved. Published 2001, 2010 by
Psychological Assessment Resources, Inc (PAR). May not
be reproduced in whole or in part in any form or by any
means without written permission of Psychological
Assessment Resources, Inc.).
C123667 MOCA MOCA01 Montreal Cognitive Assessment (MoCA) (Copyright Z. Montreal Cognitive
Nasreddine MD. Ziad S. Nasreddine, Natalie A. Phillips, Assessment Functional
Valerie Bedirian, Simon Charbonneau, Victor Whitehead, Test
Isabelle Collin, Jeffrey L. Cummings and Howard
Chertkow. The Montreal Cognitive Assessment, MoCA: A
Brief Screening Tool For Mild Cognitive Impairment. J Am
Geriatr Soc. 2005 Apr;53(4):695-9).
page 640 of 1925

C115304 FTCAT
Code Value
C115791 NHPT NHPT01 Nine-Hole Peg Test (NHPT) (Copyright 2001, National Nine-Hole Peg Functional
Multiple Sclerosis Society). Test
C150911 PACED TAPPING PTAP1 Paced Tapping (Rowe KC, Paulsen JS, Langbehn DR, et al. Paced Tapping Test
Self-paced timing detects and tracks change in prodromal Functional Test
Huntington disease. Neuropsychology. 2010;24(4):435-
442).
C115792 PASAT PASAT1 Paced Auditory Serial Addition Test (PASAT) (Copyright Paced Auditory Serial
2001, National Multiple Sclerosis Society). Addition Functional Test
C138334 PUL V1.2 PUL01 Performance of the Upper Limb Module for DMD Version Performance of the Upper
1.2 (PUL V1.2) (Mayhew A, Mazzone ES, Eagle M, et al. Limb Module for DMD 1.2
(2013). Development of the Performance of the Upper Functional Test
Limb module for Duchenne muscular dystrophy. Dev Med
Child Neurol; 55:1038-45).
C138335 PUL V2.0 PUL02 Performance of the Upper Limb Module for DMD Version Performance of the Upper
2.0 (PUL V2.0) (Mayhew A, Mazzone ES, Eagle M, et al. Limb Module for DMD 2.0
(2013). Development of the Performance of the Upper Functional Test
Limb module for Duchenne muscular dystrophy. Dev Med
Child Neurol; 55:1038-45).
C141687 RISING FROM FLOOR RISEF1 Rising From Floor (Mcdonald, C. M., Henricson, E. K., Rising From Floor Test
Nerve, 48(3), 343-356.
http://doi.org/10.1002/mus.23902).
C115793 SDMT SDMT01 Symbol Digit Modalities Test (SDMT) (Copyright 1973 by Symbol Digit Modalities
Western Psychological Services). Functional Test
C115789 SIX MINUTE WALK SIXMW1 6 Minute Walk Test (6MWT) (Goldman MD, Marrie RA, 6 Minute Walk Functional
Cohen JA. Evaluation of the six-minute walk in multiple Test
sclerosis subjects and healthy controls. Multiple Sclerosis
2008; 14: 383-390).
C115794 T25FW T25FW1 Timed 25-Foot Walk (T25FW) (Copyright 2001, National Timed 25-Foot Walk
Multiple Sclerosis Society). Functional Test
C141686 TEN METER WALK/RUN TENMW1 Ten Meter Walk/Run (Mcdonald, C. M., Henricson, E. K., Ten Meter Walk/Run Test
Nerve, 48(3), 343-356.
http://doi.org/10.1002/mus.23902).
C92205 TMT TMT01 Trail Making Test (TMT) [(Copyright Owner: Dr. Jim Hom, Trail Making Test
The Neuropsychology Center, 500 N. Central Expressway,
Suite 272, Plano TX 75074-6877. Ph: 469-429-8890,
www.neuropsych.com.)(Manual: Army Individual Test.
War Department, The Adjutant General's Office,
1944.)(Reitan RM. The Relation of the Trail Making Test
to Organic Brain Damage; Journal of Consulting
Psychology 1955 Oct 19(5):393-4.)(Reitan R.M. (1958).
The validity of the Trail Making Test as an indicator of
organic brain damage; Perceptual and Motor Skills, 8,
271-276.)].
C115795 TUG TUG01 Timed Up and Go (TUG) (Podsiadlo D, Richardson S. The Timed Up and Go
Timed 'Up & Go': a test of basic functional mobility for Functional Test
frail elderly persons. J Am Geriatr Soc. 1991; 39:142-
148).
page 641 of 1925

GAD01TC (Generalized Anxiety Disorder - 7 Questionnaire Test Code)
C103467 GAD01TC
Code Value
C103565 GAD0101 GAD01-Feeling Nervous Generalized Anxiety Disorder - 7 - Feeling nervous, GAD-7 - Feeling Nervous
Anxious or On Edge anxious or on edge. Anxious or On Edge
C103566 GAD0102 GAD01-Not Able to Generalized Anxiety Disorder - 7 - Not being able to stop GAD-7 - Not Being Able
Stop/Control Worrying or control worrying. to Stop or Control
Worrying
C103567 GAD0103 GAD01-Worrying Too Generalized Anxiety Disorder - 7 - Worrying too much GAD-7 - Worrying Too
Much About Things about different things. Much About Different
Things
C103568 GAD0104 GAD01-Trouble Relaxing Generalized Anxiety Disorder - 7 - Trouble relaxing. GAD-7 - Trouble Relaxing
C103569 GAD0105 GAD01-Being Restless Generalized Anxiety Disorder - 7 - Being so restless that GAD-7 - Being so
Hard to Sit Still it is hard to sit still. Restless That it is Hard to
Sit Still
C103570 GAD0106 GAD01-Becoming Easily Generalized Anxiety Disorder - 7 - Becoming easily GAD-7 - Becoming Easily
Annoyed/Irritable annoyed or irritable. Annoyed or Irritable
C103571 GAD0107 GAD01-Feel Generalized Anxiety Disorder - 7 - Feeling afraid as if GAD-7 - Feel Afraid as if
Afraid/Something Awful something awful might happen. Something Awful Might
Happen Happen
C103572 GAD0108 GAD01-Difficult to Generalized Anxiety Disorder - 7 - If you checked off any GAD-7 - Problems Made it
Work/Take Care Things problems, how difficult have these problems made it for Difficult to Work, Take
you to do your work, take care of things at home, or get Care of Things, or Get
along with other people? Along with Other People
C113886 GAD0109 GAD01-Total Score Generalized Anxiety Disorder - 7 - Total score. GAD-7 - Total Score
page 642 of 1925

GAD01TN (Generalized Anxiety Disorder - 7 Questionnaire Test Name)
C103466 GAD01TN
Code Value
C103570 GAD01-Becoming Easily GAD01-Becoming Easily Generalized Anxiety Disorder - 7 - Becoming easily GAD-7 - Becoming Easily
Annoyed/Irritable Annoyed/Irritable annoyed or irritable. Annoyed or Irritable
C103569 GAD01-Being Restless GAD01-Being Restless Generalized Anxiety Disorder - 7 - Being so restless that GAD-7 - Being so
Hard to Sit Still Hard to Sit Still it is hard to sit still. Restless That it is Hard to
Sit Still
C103572 GAD01-Difficult to GAD01-Difficult to Generalized Anxiety Disorder - 7 - If you checked off any GAD-7 - Problems Made it
Work/Take Care Things Work/Take Care Things problems, how difficult have these problems made it for Difficult to Work, Take
you to do your work, take care of things at home, or get Care of Things, or Get
along with other people? Along with Other People
C103571 GAD01-Feel GAD01-Feel Generalized Anxiety Disorder - 7 - Feeling afraid as if GAD-7 - Feel Afraid as if
Afraid/Something Awful Afraid/Something Awful something awful might happen. Something Awful Might
Happen Happen Happen
C103565 GAD01-Feeling Nervous GAD01-Feeling Nervous Generalized Anxiety Disorder - 7 - Feeling nervous, GAD-7 - Feeling Nervous
Anxious or On Edge Anxious or On Edge anxious or on edge. Anxious or On Edge
C103566 GAD01-Not Able to GAD01-Not Able to Generalized Anxiety Disorder - 7 - Not being able to stop GAD-7 - Not Being Able
Stop/Control Worrying Stop/Control Worrying or control worrying. to Stop or Control
Worrying
C113886 GAD01-Total Score GAD01-Total Score Generalized Anxiety Disorder - 7 - Total score. GAD-7 - Total Score
C103568 GAD01-Trouble Relaxing GAD01-Trouble Relaxing Generalized Anxiety Disorder - 7 - Trouble relaxing. GAD-7 - Trouble Relaxing
C103567 GAD01-Worrying Too GAD01-Worrying Too Generalized Anxiety Disorder - 7 - Worrying too much GAD-7 - Worrying Too
Much About Things Much About Things about different things. Much About Different
Things
page 643 of 1925

GASTRO (Gastrointestinal Test Name)
C128681 GASTRO
Code Value
C119332 Elasticity Elasticity A quantitative measurement of an organ's ability to Organ Elasticity

deform in response to physiological force and return to its
normal shape by passive elastic recoil.
C139184 Rectal Tumor to Anal Rectal Tumor to Anal A measurement of the distance between the rectal tumor Rectal Tumor to Anal
Verge Distance Verge Distance and the anal margin. Verge Distance
page 644 of 1925

GASTROCD (Gastrointestinal Test Code)
C128682 GASTROCD
Code Value
C119332 ELASTIC Elasticity A quantitative measurement of an organ's ability to Organ Elasticity

deform in response to physiological force and return to its
normal shape by passive elastic recoil.
C139184 RTAVDIST Rectal Tumor to Anal A measurement of the distance between the rectal tumor Rectal Tumor to Anal
Verge Distance and the anal margin. Verge Distance
page 645 of 1925

GCGI01TC (General Clinical Global Impressions Questionnaire Test Code)
C105138 GCGI01TC
Code Value
C105278 GCGI0101 GCGI01-Global Severity General Clinical Global Impressions - Global severity of GCGI - Global Severity of
of Pain pain. Pain
C105279 GCGI0102 GCGI01-Global General Clinical Global Impressions - Global improvement GCGI - Global
Improvement of Pain of pain. Improvement of Pain
C105280 GCGI0103 GCGI01-Global Disease General Clinical Global Impressions - Global disease GCGI - Global Disease
Status of Pain status of pain. Status of Pain
C105281 GCGI0104 GCGI01-Pain Treatment General Clinical Global Impressions - Pain treatment GCGI - Pain Treatment
Preference preference. Preference
C105282 GCGI0105 GCGI01-Global Rating of General Clinical Global Impressions - Global rating of pain GCGI - Global Rating of
Pain Medication medication. Pain Medication
page 646 of 1925

GCGI01TN (General Clinical Global Impressions Questionnaire Test Name)
C105137 GCGI01TN
Code Value
C105280 GCGI01-Global Disease GCGI01-Global Disease General Clinical Global Impressions - Global disease GCGI - Global Disease
Status of Pain Status of Pain status of pain. Status of Pain
C105279 GCGI01-Global GCGI01-Global General Clinical Global Impressions - Global improvement GCGI - Global
Improvement of Pain Improvement of Pain of pain. Improvement of Pain
C105282 GCGI01-Global Rating of GCGI01-Global Rating of General Clinical Global Impressions - Global rating of pain GCGI - Global Rating of
Pain Medication Pain Medication medication. Pain Medication
C105278 GCGI01-Global Severity GCGI01-Global Severity General Clinical Global Impressions - Global severity of GCGI - Global Severity of
of Pain of Pain pain. Pain
C105281 GCGI01-Pain Treatment GCGI01-Pain Treatment General Clinical Global Impressions - Pain treatment GCGI - Pain Treatment
Preference Preference preference. Preference
page 647 of 1925

GCS01TC (Glasgow Coma Scale NINDS Version Clinical Classification Test Code)
C124682 GCS01TC
Code Value
C124724 GCS0101 GCS01-Best Eye Glasgow Coma Scale - Best eye response. GCS NINDS Version -
Response Best Eye Response
C124725 GCS0102 GCS01-Motor Response Glasgow Coma Scale - Motor response. GCS NINDS Version -
Motor Response
C124726 GCS0103 GCS01-Verbal Response Glasgow Coma Scale - Verbal response. GCS NINDS Version -
Verbal Response
C124727 GCS0104 GCS01-Total Score Glasgow Coma Scale - Total score. GCS NINDS Version -
Total Score
C124728 GCS0105A GCS01-Confounder: GCS Glasgow Coma Scale - GCS Confounder Type: GCS GCS NINDS Version -
Accurate accurate. Confounder: GCS
Accurate
C124729 GCS0105B GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: paralytic. GCS NINDS Version -
Paralytic Confounder: Paralytic
C124730 GCS0105C GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: GCS NINDS Version -
Alcohol/Drug of Abuse alcohol/drugs of abuse. Confounder: Alcohol or
Drug of Abuse
C124731 GCS0105D GCS01-Confounder: C- Glasgow Coma Scale - GCS Confounder Type: C-spine GCS NINDS Version -
Spine Injury injury. Confounder: C-Spine
Injury
C124732 GCS0105E GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: GCS NINDS Version -
Hypoxia/Hypotension hypoxia/hypotension. Confounder: Hypoxia or
Hypotension
C124733 GCS0105F GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: GCS NINDS Version -
Hypothermia hypothermia. Confounder: Hypothermia
C124734 GCS0105G GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: sedation. GCS NINDS Version -
Sedation Confounder: Sedation
C124735 GCS0105H GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: unknown. GCS NINDS Version -
Unknown Confounder: Unknown
page 648 of 1925

GCS01TN (Glasgow Coma Scale NINDS Version Clinical Classification Test Name)
C124681 GCS01TN
Code Value
C124724 GCS01-Best Eye GCS01-Best Eye Glasgow Coma Scale - Best eye response. GCS NINDS Version -
Response Response Best Eye Response
C124730 GCS01-Confounder: GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: GCS NINDS Version -
Alcohol/Drug of Abuse Alcohol/Drug of Abuse alcohol/drugs of abuse. Confounder: Alcohol or
Drug of Abuse
C124731 GCS01-Confounder: C- GCS01-Confounder: C- Glasgow Coma Scale - GCS Confounder Type: C-spine GCS NINDS Version -
Spine Injury Spine Injury injury. Confounder: C-Spine
Injury
C124728 GCS01-Confounder: GCS GCS01-Confounder: GCS Glasgow Coma Scale - GCS Confounder Type: GCS GCS NINDS Version -
Accurate Accurate accurate. Confounder: GCS
Accurate
Hypothermia Hypothermia hypothermia. Confounder: Hypothermia
Hypoxia/Hypotension Hypoxia/Hypotension hypoxia/hypotension. Confounder: Hypoxia or
Hypotension
C124729 GCS01-Confounder: GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: paralytic. GCS NINDS Version -
Paralytic Paralytic Confounder: Paralytic
C124734 GCS01-Confounder: GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: sedation. GCS NINDS Version -
Sedation Sedation Confounder: Sedation
C124735 GCS01-Confounder: GCS01-Confounder: Glasgow Coma Scale - GCS Confounder Type: unknown. GCS NINDS Version -
Unknown Unknown Confounder: Unknown
C124725 GCS01-Motor Response GCS01-Motor Response Glasgow Coma Scale - Motor response. GCS NINDS Version -
Motor Response
C124727 GCS01-Total Score GCS01-Total Score Glasgow Coma Scale - Total score. GCS NINDS Version -
Total Score
C124726 GCS01-Verbal Response GCS01-Verbal Response Glasgow Coma Scale - Verbal response. GCS NINDS Version -
Verbal Response
page 649 of 1925

GDS01TC (Geriatric Depression Scale Questionnaire Test Code)
C106663 GDS01TC
Code Value
C106764 GDS0101 GDS01-Satisfied With Life Geriatric Depression Scale - Are you basically satisfied GDS - Basically Satisfied
with your life? With Life
C106765 GDS0102 GDS01-Dropped Activities Geriatric Depression Scale - Have you dropped many of GDS - Dropped Activities
and Interests your activities and interests? and Interests
C106766 GDS0103 GDS01-Life Is Empty Geriatric Depression Scale - Do you feel that your life is GDS - Feel Life Is Empty
empty?
C106767 GDS0104 GDS01-Bored Often Geriatric Depression Scale - Do you often get bored? GDS - Often Get Bored
C106768 GDS0105 GDS01-Hopeful About Geriatric Depression Scale - Are you hopeful about the GDS - Hopeful About
Future future? Future
C106769 GDS0106 GDS01-Bothered by Geriatric Depression Scale - Are you bothered by GDS - Bothered by
Thoughts thoughts you can't get out of your head? Thoughts
C106770 GDS0107 GDS01-Good Spirits Most Geriatric Depression Scale - Are you in good spirits most GDS - Good Spirits Most
of Time of the time? of Time
C106771 GDS0108 GDS01-Afraid of Geriatric Depression Scale - Are you afraid that GDS - Afraid of
Something Bad something bad is going to happen to you? Something Bad
Happening Happening
C106772 GDS0109 GDS01-Feel Happy Most Geriatric Depression Scale - Do you feel happy most of GDS - Feel Happy Most of
of Time the time? Time
C106773 GDS0110 GDS01-Often Feel Geriatric Depression Scale - Do you often feel helpless? GDS - Often Feel Helpless
Helpless
C106774 GDS0111 GDS01-Get Restless and Geriatric Depression Scale - Do you often get restless and GDS - Get Restless and
Fidgety fidgety? Fidgety
C106775 GDS0112 GDS01-Prefer to Stay Geriatric Depression Scale - Do you prefer to stay at GDS - Prefer to Stay
Home home, rather than going out and doing new things? Home
C106776 GDS0113 GDS01-Worry About Geriatric Depression Scale - Do you frequently worry GDS - Frequently Worry
Future about the future? About Future
C106777 GDS0114 GDS01-Memory Problems Geriatric Depression Scale - Do you feel you have more GDS - More Memory
problems with memory than most? Problems Than Most
C106778 GDS0115 GDS01-Wonderful to Be Geriatric Depression Scale - Do you think it is wonderful GDS - Think Wonderful to
Alive to be alive now? Be Alive
C106779 GDS0116 GDS01-Feel Downhearted Geriatric Depression Scale - Do you often feel GDS - Feel Downhearted
and Blue downhearted and blue? and Blue
C106780 GDS0117 GDS01-Feel Worthless Geriatric Depression Scale - Do you feel pretty worthless GDS - Feel Worthless
the way you are now?
C106781 GDS0118 GDS01-Worry About the Geriatric Depression Scale - Do you worry a lot about the GDS - Worry About the
Past past? Past
C106782 GDS0119 GDS01-Find Life Exciting Geriatric Depression Scale - Do you find life very GDS - Find Life Exciting
exciting?
C106783 GDS0120 GDS01-Hard to Start New Geriatric Depression Scale - Is it hard for you to get GDS - Hard to Start New
Projects started on new projects? Projects
C106784 GDS0121 GDS01-Feel Full of Geriatric Depression Scale - Do you feel full of energy? GDS - Feel Full of Energy
Energy
C106785 GDS0122 GDS01-Feel Hopeless Geriatric Depression Scale - Do you feel that your GDS - Feel Situation Is
situation is hopeless? Hopeless
C106786 GDS0123 GDS01-Most People Geriatric Depression Scale - Do you think that most GDS - Think Most People
Better Off Than You people are better off than you are? Better Off Than You
C106787 GDS0124 GDS01-Often Upset Over Geriatric Depression Scale -Do you frequently get upset GDS - Often Upset Over
Little Things over little things? Little Things
C106788 GDS0125 GDS01-Frequently Feel Geriatric Depression Scale - Do you frequently feel like GDS - Frequently Feel
Like Crying crying? Like Crying
C106789 GDS0126 GDS01-Trouble Geriatric Depression Scale - Do you have trouble GDS - Have Trouble
Concentrating concentrating? Concentrating
page 650 of 1925

C106663 GDS01TC
Code Value
C106790 GDS0127 GDS01-Enjoy Getting Up Geriatric Depression Scale - Do you enjoy getting up in GDS - Enjoy Getting Up in
in the Morning the morning? the Morning
C106791 GDS0128 GDS01-Avoid Social Geriatric Depression Scale - Do you prefer to avoid social GDS - Prefer to Avoid
Gatherings gatherings? Social Gatherings
C106792 GDS0129 GDS01-Easy to Make Geriatric Depression Scale - Is it easy for you to make GDS - Easy to Make
Decisions decisions? Decisions
C106793 GDS0130 GDS01-Mind as Clear as Geriatric Depression Scale - Is your mind as clear as it GDS - Mind as Clear as It
It Used to Be used to be? Used to Be
page 651 of 1925

GDS01TN (Geriatric Depression Scale Questionnaire Test Name)
C106662 GDS01TN
Code Value
C106771 GDS01-Afraid of GDS01-Afraid of Geriatric Depression Scale - Are you afraid that GDS - Afraid of
Something Bad Something Bad something bad is going to happen to you? Something Bad
Happening Happening Happening
C106791 GDS01-Avoid Social GDS01-Avoid Social Geriatric Depression Scale - Do you prefer to avoid social GDS - Prefer to Avoid
Gatherings Gatherings gatherings? Social Gatherings
C106767 GDS01-Bored Often GDS01-Bored Often Geriatric Depression Scale - Do you often get bored? GDS - Often Get Bored
C106769 GDS01-Bothered by GDS01-Bothered by Geriatric Depression Scale - Are you bothered by GDS - Bothered by
Thoughts Thoughts thoughts you can't get out of your head? Thoughts
C106765 GDS01-Dropped Activities GDS01-Dropped Activities Geriatric Depression Scale - Have you dropped many of GDS - Dropped Activities
and Interests and Interests your activities and interests? and Interests
C106792 GDS01-Easy to Make GDS01-Easy to Make Geriatric Depression Scale - Is it easy for you to make GDS - Easy to Make
Decisions Decisions decisions? Decisions
C106790 GDS01-Enjoy Getting Up GDS01-Enjoy Getting Up Geriatric Depression Scale - Do you enjoy getting up in GDS - Enjoy Getting Up in
in the Morning in the Morning the morning? the Morning
C106779 GDS01-Feel Downhearted GDS01-Feel Downhearted Geriatric Depression Scale - Do you often feel GDS - Feel Downhearted
and Blue and Blue downhearted and blue? and Blue
C106784 GDS01-Feel Full of GDS01-Feel Full of Geriatric Depression Scale - Do you feel full of energy? GDS - Feel Full of Energy
Energy Energy
C106772 GDS01-Feel Happy Most GDS01-Feel Happy Most Geriatric Depression Scale - Do you feel happy most of GDS - Feel Happy Most of
of Time of Time the time? Time
C106785 GDS01-Feel Hopeless GDS01-Feel Hopeless Geriatric Depression Scale - Do you feel that your GDS - Feel Situation Is
situation is hopeless? Hopeless
C106780 GDS01-Feel Worthless GDS01-Feel Worthless Geriatric Depression Scale - Do you feel pretty worthless GDS - Feel Worthless
the way you are now?
C106782 GDS01-Find Life Exciting GDS01-Find Life Exciting Geriatric Depression Scale - Do you find life very GDS - Find Life Exciting
exciting?
C106788 GDS01-Frequently Feel GDS01-Frequently Feel Geriatric Depression Scale - Do you frequently feel like GDS - Frequently Feel
Like Crying Like Crying crying? Like Crying
C106774 GDS01-Get Restless and GDS01-Get Restless and Geriatric Depression Scale - Do you often get restless and GDS - Get Restless and
Fidgety Fidgety fidgety? Fidgety
C106770 GDS01-Good Spirits Most GDS01-Good Spirits Most Geriatric Depression Scale - Are you in good spirits most GDS - Good Spirits Most
of Time of Time of the time? of Time
C106783 GDS01-Hard to Start New GDS01-Hard to Start New Geriatric Depression Scale - Is it hard for you to get GDS - Hard to Start New
Projects Projects started on new projects? Projects
C106768 GDS01-Hopeful About GDS01-Hopeful About Geriatric Depression Scale - Are you hopeful about the GDS - Hopeful About
Future Future future? Future
C106766 GDS01-Life Is Empty GDS01-Life Is Empty Geriatric Depression Scale - Do you feel that your life is GDS - Feel Life Is Empty
empty?
C106777 GDS01-Memory Problems GDS01-Memory Problems Geriatric Depression Scale - Do you feel you have more GDS - More Memory
problems with memory than most? Problems Than Most
C106793 GDS01-Mind as Clear as GDS01-Mind as Clear as Geriatric Depression Scale - Is your mind as clear as it GDS - Mind as Clear as It
It Used to Be It Used to Be used to be? Used to Be
C106786 GDS01-Most People GDS01-Most People Geriatric Depression Scale - Do you think that most GDS - Think Most People
Better Off Than You Better Off Than You people are better off than you are? Better Off Than You
C106773 GDS01-Often Feel GDS01-Often Feel Geriatric Depression Scale - Do you often feel helpless? GDS - Often Feel Helpless
Helpless Helpless
C106787 GDS01-Often Upset Over GDS01-Often Upset Over Geriatric Depression Scale -Do you frequently get upset GDS - Often Upset Over
Little Things Little Things over little things? Little Things
C106775 GDS01-Prefer to Stay GDS01-Prefer to Stay Geriatric Depression Scale - Do you prefer to stay at GDS - Prefer to Stay
Home Home home, rather than going out and doing new things? Home
C106764 GDS01-Satisfied With Life GDS01-Satisfied With Life Geriatric Depression Scale - Are you basically satisfied GDS - Basically Satisfied
with your life? With Life
page 652 of 1925

C106662 GDS01TN
Code Value
C106789 GDS01-Trouble GDS01-Trouble Geriatric Depression Scale - Do you have trouble GDS - Have Trouble
Concentrating Concentrating concentrating? Concentrating
C106778 GDS01-Wonderful to Be GDS01-Wonderful to Be Geriatric Depression Scale - Do you think it is wonderful GDS - Think Wonderful to
Alive Alive to be alive now? Be Alive
C106776 GDS01-Worry About GDS01-Worry About Geriatric Depression Scale - Do you frequently worry GDS - Frequently Worry
Future Future about the future? About Future
C106781 GDS01-Worry About the GDS01-Worry About the Geriatric Depression Scale - Do you worry a lot about the GDS - Worry About the
Past Past past? Past
page 653 of 1925

GDS02TC (Geriatric Depression Scale Short Form Questionnaire Test Code)
C106665 GDS02TC
Code Value
C106794 GDS0201 GDS02-Satisfied With Life Geriatric Depression Scale Short Form - Are you basically GDS-SF - Basically
satisfied with your life? Satisfied With Life
C106795 GDS0202 GDS02-Dropped Activities Geriatric Depression Scale Short Form - Have you GDS-SF - Dropped
and Interests dropped many of your activities and interests? Activities and Interests
C106796 GDS0203 GDS02-Life Is Empty Geriatric Depression Scale Short Form - Do you feel that GDS-SF - Feel Life Is
your life is empty? Empty
C106797 GDS0204 GDS02-Bored Often Geriatric Depression Scale Short Form - Do you often get GDS-SF - Often Get
bored? Bored
C106798 GDS0205 GDS02-Good Spirits Most Geriatric Depression Scale Short Form - Are you in good GDS-SF - Good Spirits
of Time spirits most of the time? Most of Time
C106799 GDS0206 GDS02-Afraid of Geriatric Depression Scale Short Form - Are you afraid GDS-SF - Afraid of
Something Bad that something bad is going to happen to you? Something Bad
Happening Happening
C106800 GDS0207 GDS02-Feel Happy Most Geriatric Depression Scale Short Form - Do you feel GDS-SF - Feel Happy
of Time happy most of the time? Most of Time
C106801 GDS0208 GDS02-Often Feel Geriatric Depression Scale Short Form - Do you often feel GDS-SF - Often Feel
Helpless helpless? Helpless
C106802 GDS0209 GDS02-Prefer to Stay Geriatric Depression Scale Short Form - Do you prefer to GDS-SF - Prefer to Stay
Home stay at home rather than going out and doing new Home
things?
C106803 GDS0210 GDS02-Memory Problems Geriatric Depression Scale Short Form - Do you feel you GDS-SF - More Memory
have more problems with memory than most? Problems Than Most
C106804 GDS0211 GDS02-Wonderful to Be Geriatric Depression Scale Short Form - Do you think it is GDS-SF - Think
Alive wonderful to be alive now? Wonderful to Be Alive
C106805 GDS0212 GDS02-Feel Worthless Geriatric Depression Scale Short Form - Do you feel GDS-SF - Feel Worthless
pretty worthless the way you are now?
C106806 GDS0213 GDS02-Feel Full of Geriatric Depression Scale Short Form - Do you feel full of GDS-SF - Feel Full of
Energy energy? Energy
C106807 GDS0214 GDS02-Feel Hopeless Geriatric Depression Scale Short Form - Do you feel that GDS-SF - Feel Situation is
your situation is hopeless? Hopeless
C106808 GDS0215 GDS02-Most People Geriatric Depression Scale Short Form - Do you think that GDS-SF - Think Most
Better Off Than You most people are better off than you are? People Better Off Than
You
page 654 of 1925

GDS02TN (Geriatric Depression Scale Short Form Questionnaire Test Name)
C106664 GDS02TN
Code Value
C106799 GDS02-Afraid of GDS02-Afraid of Geriatric Depression Scale Short Form - Are you afraid GDS-SF - Afraid of
Something Bad Something Bad that something bad is going to happen to you? Something Bad
Happening Happening Happening
C106797 GDS02-Bored Often GDS02-Bored Often Geriatric Depression Scale Short Form - Do you often get GDS-SF - Often Get
bored? Bored
C106795 GDS02-Dropped Activities GDS02-Dropped Activities Geriatric Depression Scale Short Form - Have you GDS-SF - Dropped
and Interests and Interests dropped many of your activities and interests? Activities and Interests
C106806 GDS02-Feel Full of GDS02-Feel Full of Geriatric Depression Scale Short Form - Do you feel full of GDS-SF - Feel Full of
Energy Energy energy? Energy
C106800 GDS02-Feel Happy Most GDS02-Feel Happy Most Geriatric Depression Scale Short Form - Do you feel GDS-SF - Feel Happy
of Time of Time happy most of the time? Most of Time
C106807 GDS02-Feel Hopeless GDS02-Feel Hopeless Geriatric Depression Scale Short Form - Do you feel that GDS-SF - Feel Situation is
your situation is hopeless? Hopeless
C106805 GDS02-Feel Worthless GDS02-Feel Worthless Geriatric Depression Scale Short Form - Do you feel GDS-SF - Feel Worthless
pretty worthless the way you are now?
C106798 GDS02-Good Spirits Most GDS02-Good Spirits Most Geriatric Depression Scale Short Form - Are you in good GDS-SF - Good Spirits
of Time of Time spirits most of the time? Most of Time
C106796 GDS02-Life Is Empty GDS02-Life Is Empty Geriatric Depression Scale Short Form - Do you feel that GDS-SF - Feel Life Is
your life is empty? Empty
C106803 GDS02-Memory Problems GDS02-Memory Problems Geriatric Depression Scale Short Form - Do you feel you GDS-SF - More Memory
have more problems with memory than most? Problems Than Most
C106808 GDS02-Most People GDS02-Most People Geriatric Depression Scale Short Form - Do you think that GDS-SF - Think Most
Better Off Than You Better Off Than You most people are better off than you are? People Better Off Than
You
C106801 GDS02-Often Feel GDS02-Often Feel Geriatric Depression Scale Short Form - Do you often feel GDS-SF - Often Feel
Helpless Helpless helpless? Helpless
C106802 GDS02-Prefer to Stay GDS02-Prefer to Stay Geriatric Depression Scale Short Form - Do you prefer to GDS-SF - Prefer to Stay
Home Home stay at home rather than going out and doing new Home
things?
C106794 GDS02-Satisfied With Life GDS02-Satisfied With Life Geriatric Depression Scale Short Form - Are you basically GDS-SF - Basically
satisfied with your life? Satisfied With Life
C106804 GDS02-Wonderful to Be GDS02-Wonderful to Be Geriatric Depression Scale Short Form - Do you think it is GDS-SF - Think
Alive Alive wonderful to be alive now? Wonderful to Be Alive
page 655 of 1925

GENRTYP (Genetic Region of Interest Type)
C132317 GENRTYP
Code Value
C16612 GENE A functional unit of heredity which occupies a specific Gene

position on a particular chromosome and serves as the
template for a product that contributes to a phenotype or
a biological function. (NCI)
C13338 MICROSATELLITE A variety of simple 2-5 base pair repeats (e.g., T-A Microsatellite Repeat
repeats, variable number of tandem repeats (VNTRs),
etc.) present within most chromosomes. (NCI)
page 656 of 1925

GENSMP (Genetic Sample Type)
C111114 GENSMP
Code Value
C95951 7SK RNA 7SK Small Nuclear RNA;7SK snRNA 7SK small nuclear RNA is encoded by the 7SK Small Nuclear RNA
human RN7SK gene. This oligoribonucleotide
may play a role in the regulation of the
enzymatic activity of RNA polymerase II.
C324 cDNA Complementary DNA Single-stranded DNA that is complementary to cDNA

messenger RNA or DNA that has been
synthesized from messenger RNA by reverse
transcriptase.
C111158 cpDNA Chloroplast DNA The DNA that is located in the photosynthetic, Chloroplast DNA
chlorophyll-containing organelle in the cells of
young leaves and stems of higher plants. (NCI)
C113243 ctDNA Cell-Free Circulating Tumor A type of cell-free DNA composed of small Circulating Tumor-
DNA;Circulating Tumor DNA fragments of tumor DNA that are released by Derived DNA
tumor cells into the bloodstream of the host.
C449 DNA Deoxyribonucleic Acid;Double- A long linear double-stranded polymer formed DNA
stranded DNA;dsDNA from nucleotides attached to a deoxyribose
backbone; associated with the transmission of
genetic information.
C95938 dsRNA Double-stranded RNA An RNA complex consisting of two base-paired Double-Stranded RNA
strands of complementary RNA.
C95940 gDNA Genomic DNA The DNA that is part of the normal Genomic DNA
chromosomal complement of an organism.
C95952 gRNA Guide RNA A small RNA involved in post-transcriptional Guide RNA
mitochondrial RNA modification (RNA editing) in
kinetoplastids.
C28454 hnRNA Heterogeneous Nuclear RNA A diverse assortment of nascent, immature, hnRNA
unprocessed RNA transcripts synthesized from
DNA templates that are found in eukaryotic
nuclei before post-transcriptional modifications.
C25966 miRNA MicroRNA A sequence of single-stranded RNA which is MicroRNA

typically 20-25 nucleotides in length and may
regulate the expression of other genes. miRNAs
are transcribed from DNA, but are not
translated into proteins.
C813 mRNA Messenger RNA A class of RNA molecule containing protein- Messenger RNA
coding information in its nucleotide sequence
that can be translated into the amino acid
sequence of a protein.
C111279 msDNA Multicopy Single-stranded DNA A DNA/RNA chimera comprised of a single- Multicopy Single-stranded
stranded DNA molecule covalently bound to an DNA
internal guanosine of a RNA molecule. (NCI)
C111278 msdRNA MSR The RNA portion of the msDNA molecule, which msdRNA
contains two stem-loop structures and varies
widely in length across bacterial species. (NCI)
C28512 mtDNA Mitochondrial DNA;mDNA Typically small, circular, intronless, and Mitochondrial DNA
maternally inherited, mitochondrial DNA
(mtDNA) is the multicopy deoxyribonucleic acid
genome of mitochondria, intracellular
organelles responsible for vital respiratory
chain and oxidative phosphorylation reactions
in higher eukaryotes. Replicated and
transcribed by a separate enzymatic machinery
from that of nuclear DNA, mtDNA encodes only
a subset of mitochondrial functions.
C95941 nDNA Nuclear DNA The DNA that is normally located in the nucleus Nuclear DNA
of a eukaryotic cell.
C754 pDNA Plasmid;Plasmid DNA A small cellular inclusion consisting of a ring of Plasmid
DNA that is not in a chromosome but is capable
of autonomous replication.
C95953 piRNA Piwi-Interacting RNA Single-stranded RNA molecules that are Piwi-Interacting RNA
expressed in animal cells and form complexes
with Piwi proteins. They are involved in
transcriptional gene silencing.
page 657 of 1925

C111114 GENSMP
Code Value
C111298 pre-mRNA Precursor mRNA A primary RNA transcript synthesized from a Precursor mRNA
DNA template in eukaryotic nuclei which is
post-transcriptionally modified and spliced to
produce a mature mRNA. (NCI)
C25967 pri-miRNA Pri-MIR;Pri-miRNA;Pri- The pri-miRNA is a primary transcript derived Pri-miRNA

microRNA;Primary MicroRNA from a gene whose sole products are miRNA(s).
A unique pathway involving the nuclear
microprocessor complex participates in the
cleavage of such transcripts, which can be
substantially longer than the 65-110 nt pre-
miRNA.
C95943 rDNA Ribosomal DNA;Ribosomal RNA The genomic sequences that code for ribosomal Ribosomal RNA Gene
Genes RNA molecules.
C1292 RIBOZYME Catalytic RNA;Ribonucleic Enzyme RNA that contains an intron sequence which Ribozyme
has an enzyme-like catalytic activity. This
intron sequence can function like an enzyme in
reactions with other RNA molecules and thus
synthesize new molecules even in the absence
of protein.
C812 RNA Ribonucleic Acid Single-stranded long chain of nucleotides Ribonucleic Acid
containing ribose. It is the end product of DNA
transcription by the enzyme RNA polymerase.
It is essential in protein synthesis.
C814 rRNA Ribosomal RNA An RNA molecule that does not contain protein- Ribosomal RNA
coding sequence information and constitutes
the majority of the cellular RNA (~80%). This
nucleic acid associates with multiple proteins to
form ribosomes, which are the organelles that
drive mRNA-directed protein synthesis.
C2191 siRNA Small Interfering RNA A 20 to 25-nucleotide double-stranded RNA Small Interfering RNA
which is involved in a sequence-specific
messenger RNA degradation process known as
RNA interference.
C111316 snoRNA Small Nucleolar RNA Small RNA molecules that are present in the Small Nucleolar RNA
nucleolus. They associate with proteins to form
small nucleolar ribonucleoprotein particles that
are involved in modification of other RNAs.
(NCI)
C815 snRNA Small Nuclear RNA;Small Nuclear A small RNA molecule (100-300 nucleotides) Small Nuclear RNA
Ribonucleic Acid;U-RNA located in the cell nucleus. This nucleic acid
plays a role in RNA splicing, transcriptional
regulation, telomere maintenance and rRNA
modification.
C95950 SRP RNA 7SL RNA;SRP RNA;Signal A non-coding RNA that is part of the signal Signal Recognition
Recognition Particle RNA;srpRNA recognition particle. It is involved in the co- Particle RNA
translational targeting of proteins to
membranes.
C111311 ssDNA Single-stranded DNA A long linear single-stranded polymer formed Single-stranded DNA
from nucleotides attached to a deoxyribose
backbone. (NCI)
C95954 tmRNA 10Sa RNA;SsrA;Transfer-Messenger An RNA encoded by the bacterial ssrA gene. It Transfer-Messenger RNA
RNA is involved in the recycling of stalled ribosomes
and the targeting of both defective mRNA
molecules and incomplete nascent proteins for
degradation.
C95942 TRANSPOSON Jumping Gene;Jumping A class of mobile genetic elements that can Transposon
Genes;Transposable Element move from one genomic position to another.
C816 tRNA Transfer RNA;Triplet Codon-Amino A class of short adaptor RNAs that transfers a Transfer RNA
Acid Adaptor specific amino acid to a growing polypeptide
chain at the ribosomal site of protein synthesis
during translation. Each transfer RNA comprises
a three-nucleotide sequence that is
complementary to the triplet nucleotide coding
sequence of an mRNA, conferring specificity to
the amino acid being incorporated into the
assembling protein.
page 658 of 1925

GNRLOBSC (General Observation Class)
C103329 GNRLOBSC
Code Value
C103375 ADAM OTHER An analysis dataset that doesn't conform to a pre-defined CDISC Other ADaM
ADaM dataset structure (e.g. ADSL, BDS or OCCDS). Dataset
C103371 BASIC DATA STRUCTURE BDS An ADaM BDS dataset contains one or more records per CDISC Basic Data
subject, per analysis parameter, per analysis time point. Structure Dataset
Variables include the value being analyzed (e.g., AVAL)
and the description of the value being analyzed (e.g.,
PARAM). Other variables in the dataset provide more
information about the value being analyzed (e.g., the
subject identification) or describe and trace the derivation
of it (e.g., DTYPE) or support the analysis of it (e.g.,
treatment variables, covariates).
C103372 EVENTS This SDTM class captures planned protocol milestones CDISC Events Class
such as randomization and study completion, and
occurrences, conditions, or incidents independent of
planned study evaluations occurring during the trial (e.g.,
adverse events) or prior to the trial (e.g., medical
history).
C103373 FINDINGS This SDTM class captures the observations resulting from CDISC Findings Class
planned evaluations to address specific tests or questions
such as laboratory tests, ECG testing, and questions
listed on questionnaires.
C135396 FINDINGS ABOUT This SDTM class is a specialization of the findings general CDISC Findings About
observation class. It is intended, as its name implies, to Class
be used when collected data represent findings about an
event or intervention that cannot be represented within
an event or intervention record or as a supplemental
qualifier to such a record.
C132357 INTEGRATED BASIC IBDS IBDS is the ADaM Model for the Integrated Basic Data CDISC Integrated Basic
DATA STRUCTURE Structure. The structure includes per pool as defined in Data Structure Dataset
the integrated SAP when multiple records per subject are
included in integrated ADSL.
C132358 INTEGRATED IOCCDS IOCCDS is the ADaM Model for Integrated Occurrence CDISC Integrated
OCCURRENCE DATA Data structure. The structure includes per pool as defined Occurrence Data
STRUCTURE in the integrated SAP when multiple records per subject Structure Dataset
are included in integrated ADSL.
C132359 INTEGRATED SUBJECT IADSL IADSL is the ADaM Model for Integrated Subject Level CDISC Integrated Subject
LEVEL Analysis Dataset. The structure is one record per subject Level Dataset
per pool as defined in the integrated SAP. Multiple
records per subject are required in an integrated ADSL
dataset when any subject's data is used in more than one
pool and the values for subject-level variables differ
across pools.
C103374 INTERVENTIONS This SDTM class captures investigational, therapeutic and CDISC Interventions
other treatments that are administered to the subject Class
(with some actual or expected physiological effect) either
as specified by the study protocol (e.g., exposure to
study drug), coincident with the study assessment period
(e.g., concomitant medications), or self-administered by
the subject (such as use of alcohol, tobacco, or caffeine).
C123454 OCCURRENCE DATA OCCDS The Occurrence Data Structure (OCCDS) is the ADaM CDISC Occurrence Data
STRUCTURE data structure for occurrence analysis. Occurrence Structure
analysis is the counting of subjects with a record or term,
and often includes a structured hierarchy of dictionary
coding categories.
C103376 RELATIONSHIP This SDTM class provides a means to link related records CDISC Relationship Class
between datasets. It includes the RELREC and SUPPQUAL
datasets.
C103377 SPECIAL PURPOSE This SDTM class contains a set of domains which do not CDISC Special Purpose
conform to the Findings, Events or Interventions Class
observation classes. The domains included are DM, CO,
SE and SV.
C147271 STUDY REFERENCE This special purpose SDTM class contains further CDISC Study Reference
descriptions of study-specific identifiers that will be used Class
in subject based domains.
page 659 of 1925

C103329 GNRLOBSC
Code Value
C103378 SUBJECT LEVEL ADSL The Subject-Level Analysis Dataset (ADSL) is a one- CDISC Subject Level
ANALYSIS DATASET record-per-subject dataset which contains variables that Analysis Dataset
describe subject demographic characteristics and group
the subjects for analysis. ADSL is the primary source for
subject-level variables included in other analysis datasets
such as population flags and treatment variables.
C103379 TRIAL DESIGN This SDTM class describes the plan for the procedures to CDISC Trial Design Class
be followed in a clinical trial, including planned and actual
timing of events, control group, method of allocating
treatments, blinding methods, assignment of epochs that
subjects pass through in the course of a trial.
page 660 of 1925

GOSE1TC (Extended Glasgow Outcome Scale Questionnaire Test Code)
C115404 GOSE1TC
Code Value
C115828 GOSE101 GOSE1-Obey Simple Extended Glasgow Outcome Scale - Is the head injured GOSE - Consciousness:
Commands or Say Words person able to obey simple commands, or say any words? Obey Simple Commands
C115829 GOSE102A GOSE1-Daily Assistance Extended Glasgow Outcome Scale - Is the assistance of GOSE - Independence in
at Home Essential another person at home essential every day for some the Home: Assistance
activities of daily living? Essential for Daily Living
C115830 GOSE102B GOSE1-Need Frequent Extended Glasgow Outcome Scale - Do they need GOSE - Independence in
Help at Home frequent help or someone to be around at home most of the Home: Need Frequent
the time? Help at Home
C115831 GOSE102C GOSE1-Assistance at Extended Glasgow Outcome Scale - Was assistance at GOSE - Independence in
Home Before Injury home essential before the injury? the Home: Assistance at
Home Before Injury
C115832 GOSE103A GOSE1-Shop Without Extended Glasgow Outcome Scale - Are they able to shop GOSE - Independence
Assistance without assistance? Outside the Home: Able
to Shop Without
Assistance
C115833 GOSE103B GOSE1-Shop Without Extended Glasgow Outcome Scale - Were they able to GOSE - Independence
Assist Before Injury shop without assistance before the injury? Outside the Home: Able
to Shop Without
Assistance Before Injury
C115834 GOSE104A GOSE1-Travel Locally Extended Glasgow Outcome Scale - Are they able to GOSE - Independence
Without Assistance travel locally without assistance? Outside the Home: Travel
Locally Without
Assistance
C115835 GOSE104B GOSE1-Travel Without Extended Glasgow Outcome Scale - Were they able to GOSE - Independence
Assist Before Inj travel without assistance before the injury? Outside the Home: Travel
Locally Without
C115836 GOSE105A GOSE1-Able to Work to Extended Glasgow Outcome Scale - Are they currently GOSE - Work: Able to
Previous Capacity able to work to their previous capacity? Work to Previous
Capacity
C115837 GOSE105B GOSE1-How Restricted Extended Glasgow Outcome Scale - How restricted are GOSE - Work: How
Are They they? Restricted Are They
C115838 GOSE105C GOSE1-Working Before Extended Glasgow Outcome Scale - Were they either GOSE - Work: Working or
Injury working or seeking employment before the injury (answer Seeking Employment
'yes') or were they doing neither (answer 'no')? Before the Injury
C115839 GOSE106A GOSE1-Resume Extended Glasgow Outcome Scale - Are they able to GOSE - Social and Leisure
Social/Leisure Outside resume regular social and leisure activities outside home? Activities: Resume
Home Regular Social and
Leisure Activities
C115840 GOSE106B GOSE1-Extent Extended Glasgow Outcome Scale - What is the extent of GOSE - Social and Leisure
Social/Leisure Restriction restriction on their social and leisure activities? Activities: Extent of
Restriction on Social and
Leisure Activities
C115841 GOSE106C GOSE1-Engage Extended Glasgow Outcome Scale - Did they engage in GOSE - Social and Leisure
Social/Leisure Before Inj regular social and leisure activities outside home before Activities: Engage
the injury? Regular Social and
Leisure Activities Before
Injury
C115842 GOSE107A GOSE1-Disruptive Extended Glasgow Outcome Scale - Have there been GOSE - Family and
Psychological Problems psychological problems which have resulted in ongoing Friendships: Disruptive
family disruption or disruption to friendships? Psychological Problems
C115843 GOSE107B GOSE1-Extent of Extended Glasgow Outcome Scale - What has been the GOSE - Family and
Disruption extent of disruption or strain? Friendships: Extent of
Disruption or Strain
C115844 GOSE107C GOSE1-Family/Friends Extended Glasgow Outcome Scale - Were there problems GOSE - Family and
Probs Before Injury with family or friends before the injury? Friendships: Problems
with Family or Friends
Before Injury
C115845 GOSE108A GOSE1-Other Problems Extended Glasgow Outcome Scale - Are there any other GOSE - Return to Normal
Related to Injury current problems relating to the injury which affect daily Life: Other Current
life? Problems Relating to
Injury
page 661 of 1925

C115404 GOSE1TC
Code Value
C115846 GOSE108B GOSE1-Similar Problems Extended Glasgow Outcome Scale - Were similar GOSE - Return to Normal
Before Injury problems present before the injury? Life: Similar Problems
Before Injury
C115847 GOSE109 GOSE1-Since Injury Any Extended Glasgow Outcome Scale - Since the injury has GOSE - Epilepsy: Since
Epileptic Fits the head injured person had any epileptic fits? Injury Any Epileptic Fits
C115848 GOSE110 GOSE1-At Risk of Extended Glasgow Outcome Scale - Have they been told GOSE - Epilepsy: At Risk
Developing Epilepsy that they are currently at risk of developing epilepsy? of Developing Epilepsy
C115849 GOSE111 GOSE1-Most Important Extended Glasgow Outcome Scale - What is the most GOSE - Epilepsy: Most
Factor in Outcome important factor in outcome? Important Factor in
Outcome
C115850 GOSE112 GOSE1-GOSE Overall Extended Glasgow Outcome Scale - Scoring: The patient's GOSE - GOSE Overall
Score overall rating is based on the lowest outcome category Score
indicated on the scale.
page 662 of 1925

GOSE1TN (Extended Glasgow Outcome Scale Questionnaire Test Name)
C115403 GOSE1TN
Code Value
C115836 GOSE1-Able to Work to GOSE1-Able to Work to Extended Glasgow Outcome Scale - Are they currently GOSE - Work: Able to
Previous Capacity Previous Capacity able to work to their previous capacity? Work to Previous
Capacity
C115831 GOSE1-Assistance at GOSE1-Assistance at Extended Glasgow Outcome Scale - Was assistance at GOSE - Independence in
Home Before Injury Home Before Injury home essential before the injury? the Home: Assistance at
Home Before Injury
C115848 GOSE1-At Risk of GOSE1-At Risk of Extended Glasgow Outcome Scale - Have they been told GOSE - Epilepsy: At Risk
Developing Epilepsy Developing Epilepsy that they are currently at risk of developing epilepsy? of Developing Epilepsy
C115829 GOSE1-Daily Assistance GOSE1-Daily Assistance Extended Glasgow Outcome Scale - Is the assistance of GOSE - Independence in
at Home Essential at Home Essential another person at home essential every day for some the Home: Assistance
activities of daily living? Essential for Daily Living
C115842 GOSE1-Disruptive GOSE1-Disruptive Extended Glasgow Outcome Scale - Have there been GOSE - Family and
Psychological Problems Psychological Problems psychological problems which have resulted in ongoing Friendships: Disruptive
family disruption or disruption to friendships? Psychological Problems
C115841 GOSE1-Engage GOSE1-Engage Extended Glasgow Outcome Scale - Did they engage in GOSE - Social and Leisure
Social/Leisure Before Inj Social/Leisure Before Inj regular social and leisure activities outside home before Activities: Engage
the injury? Regular Social and
Leisure Activities Before
Injury
C115843 GOSE1-Extent of GOSE1-Extent of Extended Glasgow Outcome Scale - What has been the GOSE - Family and
Disruption Disruption extent of disruption or strain? Friendships: Extent of
Disruption or Strain
C115840 GOSE1-Extent GOSE1-Extent Extended Glasgow Outcome Scale - What is the extent of GOSE - Social and Leisure
Social/Leisure Restriction Social/Leisure Restriction restriction on their social and leisure activities? Activities: Extent of
Restriction on Social and
Leisure Activities
C115844 GOSE1-Family/Friends GOSE1-Family/Friends Extended Glasgow Outcome Scale - Were there problems GOSE - Family and
Probs Before Injury Probs Before Injury with family or friends before the injury? Friendships: Problems
with Family or Friends
Before Injury
C115850 GOSE1-GOSE Overall GOSE1-GOSE Overall Extended Glasgow Outcome Scale - Scoring: The patient's GOSE - GOSE Overall
Score Score overall rating is based on the lowest outcome category Score
indicated on the scale.
C115837 GOSE1-How Restricted GOSE1-How Restricted Extended Glasgow Outcome Scale - How restricted are GOSE - Work: How
Are They Are They they? Restricted Are They
C115849 GOSE1-Most Important GOSE1-Most Important Extended Glasgow Outcome Scale - What is the most GOSE - Epilepsy: Most
Factor in Outcome Factor in Outcome important factor in outcome? Important Factor in
Outcome
C115830 GOSE1-Need Frequent GOSE1-Need Frequent Extended Glasgow Outcome Scale - Do they need GOSE - Independence in
Help at Home Help at Home frequent help or someone to be around at home most of the Home: Need Frequent
the time? Help at Home
C115828 GOSE1-Obey Simple GOSE1-Obey Simple Extended Glasgow Outcome Scale - Is the head injured GOSE - Consciousness:
Commands or Say Words Commands or Say Words person able to obey simple commands, or say any words? Obey Simple Commands
C115845 GOSE1-Other Problems GOSE1-Other Problems Extended Glasgow Outcome Scale - Are there any other GOSE - Return to Normal
Related to Injury Related to Injury current problems relating to the injury which affect daily Life: Other Current
life? Problems Relating to
Injury
C115839 GOSE1-Resume GOSE1-Resume Extended Glasgow Outcome Scale - Are they able to GOSE - Social and Leisure
Social/Leisure Outside Social/Leisure Outside resume regular social and leisure activities outside home? Activities: Resume
Home Home Regular Social and
Leisure Activities
C115833 GOSE1-Shop Without GOSE1-Shop Without Extended Glasgow Outcome Scale - Were they able to GOSE - Independence
Assist Before Injury Assist Before Injury shop without assistance before the injury? Outside the Home: Able
to Shop Without
C115832 GOSE1-Shop Without GOSE1-Shop Without Extended Glasgow Outcome Scale - Are they able to shop GOSE - Independence
Assistance Assistance without assistance? Outside the Home: Able
to Shop Without
Assistance
C115846 GOSE1-Similar Problems GOSE1-Similar Problems Extended Glasgow Outcome Scale - Were similar GOSE - Return to Normal
Before Injury Before Injury problems present before the injury? Life: Similar Problems
Before Injury
page 663 of 1925

C115403 GOSE1TN
Code Value
C115847 GOSE1-Since Injury Any GOSE1-Since Injury Any Extended Glasgow Outcome Scale - Since the injury has GOSE - Epilepsy: Since
Epileptic Fits Epileptic Fits the head injured person had any epileptic fits? Injury Any Epileptic Fits
C115834 GOSE1-Travel Locally GOSE1-Travel Locally Extended Glasgow Outcome Scale - Are they able to GOSE - Independence
Without Assistance Without Assistance travel locally without assistance? Outside the Home: Travel
Locally Without
Assistance
C115835 GOSE1-Travel Without GOSE1-Travel Without Extended Glasgow Outcome Scale - Were they able to GOSE - Independence
Assist Before Inj Assist Before Inj travel without assistance before the injury? Outside the Home: Travel
Locally Without
C115838 GOSE1-Working Before GOSE1-Working Before Extended Glasgow Outcome Scale - Were they either GOSE - Work: Working or
Injury Injury working or seeking employment before the injury (answer Seeking Employment
'yes') or were they doing neither (answer 'no')? Before the Injury
page 664 of 1925

GRAFTTYP (Graft Type)
C117737 GRAFTTYP
Code Value
C117816 ARTERIAL GRAFT, FREE A vessel graft comprised of an artery that has been Free Arterial Graft
completely detached from its original location. (NCI)
C117817 ARTERIAL GRAFT, IN- A vessel graft comprised of an artery whose origin In Situ Arterial Graft
SITU remains intact.
C117818 AUTOLOGOUS VEIN A vessel graft comprised of a vein harvested from a Autologous Vein Graft
GRAFT different anatomical location.
C117819 CADAVERIC GRAFT, An arterial graft harvested from a cadaver. (NCI) Cadaveric Arterial Graft
ARTERIAL
C117820 CADAVERIC GRAFT, A venous graft harvested from a cadaver. (NCI) Cadaveric Venous Graft
VENOUS
C117821 COMPOSITE GRAFT A vessel graft comprised of two or more conduit Composite Vessel Graft
materials.
C117822 SAPHENOUS VEIN GRAFT SVG A vessel graft comprised of the saphenous vein. Saphenous Vein Graft
C117823 SYNTHETIC GRAFT A vessel graft comprised of non-biological material. Synthetic Vessel Graft
page 665 of 1925

GRSTNLOC (Location of Most Severe Stenosis Within a Graft)
C101851 GRSTNLOC
Code Value
C99915 AORTIC ANASTOMOSIS The connection where the graft joins the aorta usually Aortic Anastomosis of
OF THE GRAFT less than or equal to 3 mm from insertion point. Graft
C99918 BODY OF THE GRAFT The portion of the graft that lies between its Body of Graft
anastomoses.
C80476 CORONARY Coronary Graft The connection where the graft joins the coronary artery Coronary Graft
ANASTOMOSIS OF THE Anastomoses usually less than or equal to 3 mm from insertion point. Anastomoses
GRAFT
page 666 of 1925

HADS01TC (Hospital Anxiety and Depression Scale Questionnaire Test Code)
C103469 HADS01TC
Code Value
C103573 HADS0101 HADS01-I Feel Tense or Hospital Anxiety and Depression Scale - I feel tense or HADS - I Feel Tense or
Wound Up 'wound up.' Wound Up
C103574 HADS0102 HADS01-Enjoy the Things Hospital Anxiety and Depression Scale - I still enjoy the HADS - I Still Enjoy the
I Used to Enjoy things I used to enjoy. Things I Used to Enjoy
C103575 HADS0103 HADS01-Something Awful Hospital Anxiety and Depression Scale - I get a sort of HADS - I Get a
About to Happen frightened feeling as if something awful is about to Frightened Feeling
happen. Something Awful is About
to Happen
C103576 HADS0104 HADS01-I Can Laugh and Hospital Anxiety and Depression Scale - I can laugh and HADS - I Can Laugh and
See Funny Side see the funny side of things. See Funny Side of Things
C103577 HADS0105 HADS01-Worrying Hospital Anxiety and Depression Scale - Worrying HADS - Worrying
Thoughts Go Through thoughts go through my mind. Thoughts Go Through My
Mind Mind
C103578 HADS0106 HADS01-I Feel Cheerful Hospital Anxiety and Depression Scale - I feel cheerful. HADS - I Feel Cheerful
C103579 HADS0107 HADS01-Sit at Ease and Hospital Anxiety and Depression Scale - I can sit at ease HADS - I Can Sit at Ease
Feel Relaxed and feel relaxed. and Feel Relaxed
C103580 HADS0108 HADS01-I Feel as if I am Hospital Anxiety and Depression Scale - I feel as if I am HADS - I Feel as if I am
Slowed Down slowed down. Slowed Down
C103581 HADS0109 HADS01-Butterflies in the Hospital Anxiety and Depression Scale - I get a sort of HADS - I Get Frightened
Stomach frightened feeling like 'butterflies' in the stomach. Feeling Like Butterflies in
the Stomach
C103582 HADS0110 HADS01-Lost Interest in Hospital Anxiety and Depression Scale - I have lost HADS - I Have Lost
My Appearance interest in my appearance. Interest in My
Appearance
C103583 HADS0111 HADS01-Feel Restless be Hospital Anxiety and Depression Scale - I feel restless as HADS - I Feel Restless as
on the Move if I have to be on the move. if I Have to be on the
Move
C103584 HADS0112 HADS01-Look Forward Hospital Anxiety and Depression Scale - I look forward HADS - I Look Forward
with Enjoyment with enjoyment to things. with Enjoyment to Things
C103585 HADS0113 HADS01-I Get Sudden Hospital Anxiety and Depression Scale - I get sudden HADS - I Get Sudden
Feelings of Panic feelings of panic. Feelings of Panic
C103586 HADS0114 HADS01-Enjoy Good Hospital Anxiety and Depression Scale - I can enjoy a HADS - I Can Enjoy a
Book/Radio/Television good book or radio or television programme. Good Book or Radio or
Television Programme
C118111 HADS0115 HADS01-Total Score Hospital Anxiety and Depression Scale - Total score HADS - Total Score
Anxiety anxiety. Anxiety
C118112 HADS0116 HADS01-Total Score Hospital Anxiety and Depression Scale - Total score HADS - Total Score
Depression depression. Depression
page 667 of 1925

HADS01TN (Hospital Anxiety and Depression Scale Questionnaire Test Name)
C103468 HADS01TN
Code Value
C103581 HADS01-Butterflies in the HADS01-Butterflies in the Hospital Anxiety and Depression Scale - I get a sort of HADS - I Get Frightened
Stomach Stomach frightened feeling like 'butterflies' in the stomach. Feeling Like Butterflies in
the Stomach
C103586 HADS01-Enjoy Good HADS01-Enjoy Good Hospital Anxiety and Depression Scale - I can enjoy a HADS - I Can Enjoy a
Book/Radio/Television Book/Radio/Television good book or radio or television programme. Good Book or Radio or
Television Programme
C103574 HADS01-Enjoy the Things HADS01-Enjoy the Things Hospital Anxiety and Depression Scale - I still enjoy the HADS - I Still Enjoy the
I Used to Enjoy I Used to Enjoy things I used to enjoy. Things I Used to Enjoy
C103583 HADS01-Feel Restless be HADS01-Feel Restless be Hospital Anxiety and Depression Scale - I feel restless as HADS - I Feel Restless as
on the Move on the Move if I have to be on the move. if I Have to be on the
Move
C103576 HADS01-I Can Laugh and HADS01-I Can Laugh and Hospital Anxiety and Depression Scale - I can laugh and HADS - I Can Laugh and
See Funny Side See Funny Side see the funny side of things. See Funny Side of Things
C103580 HADS01-I Feel as if I am HADS01-I Feel as if I am Hospital Anxiety and Depression Scale - I feel as if I am HADS - I Feel as if I am
Slowed Down Slowed Down slowed down. Slowed Down
C103578 HADS01-I Feel Cheerful HADS01-I Feel Cheerful Hospital Anxiety and Depression Scale - I feel cheerful. HADS - I Feel Cheerful
C103573 HADS01-I Feel Tense or HADS01-I Feel Tense or Hospital Anxiety and Depression Scale - I feel tense or HADS - I Feel Tense or
Wound Up Wound Up 'wound up.' Wound Up
C103585 HADS01-I Get Sudden HADS01-I Get Sudden Hospital Anxiety and Depression Scale - I get sudden HADS - I Get Sudden
Feelings of Panic Feelings of Panic feelings of panic. Feelings of Panic
C103584 HADS01-Look Forward HADS01-Look Forward Hospital Anxiety and Depression Scale - I look forward HADS - I Look Forward
with Enjoyment with Enjoyment with enjoyment to things. with Enjoyment to Things
C103582 HADS01-Lost Interest in HADS01-Lost Interest in Hospital Anxiety and Depression Scale - I have lost HADS - I Have Lost
My Appearance My Appearance interest in my appearance. Interest in My
Appearance
C103579 HADS01-Sit at Ease and HADS01-Sit at Ease and Hospital Anxiety and Depression Scale - I can sit at ease HADS - I Can Sit at Ease
Feel Relaxed Feel Relaxed and feel relaxed. and Feel Relaxed
C103575 HADS01-Something Awful HADS01-Something Awful Hospital Anxiety and Depression Scale - I get a sort of HADS - I Get a
About to Happen About to Happen frightened feeling as if something awful is about to Frightened Feeling
happen. Something Awful is About
to Happen
C118111 HADS01-Total Score HADS01-Total Score Hospital Anxiety and Depression Scale - Total score HADS - Total Score
Anxiety Anxiety anxiety. Anxiety
C118112 HADS01-Total Score HADS01-Total Score Hospital Anxiety and Depression Scale - Total score HADS - Total Score
Depression Depression depression. Depression
C103577 HADS01-Worrying HADS01-Worrying Hospital Anxiety and Depression Scale - Worrying HADS - Worrying
Thoughts Go Through Thoughts Go Through thoughts go through my mind. Thoughts Go Through My
Mind Mind Mind
page 668 of 1925

HAI01TC (Hauser Ambulation Index Functional Test Test Code)
C115390 HAI01TC
Code Value
C115806 HAI0101 HAI01-Ambulation Index Hauser Ambulation Index - Ambulation index. HAI - Ambulation Index
page 669 of 1925

HAI01TN (Hauser Ambulation Index Functional Test Test Name)
C115389 HAI01TN
Code Value
C115806 HAI01-Ambulation Index HAI01-Ambulation Index Hauser Ambulation Index - Ambulation index. HAI - Ambulation Index
page 670 of 1925

HAMA1TC (Hamilton Anxiety Rating Scale Clinical Classification Test Code)
C101819 HAMA1TC
Code Value
C102073 HAMA101 HAMA1-Anxious Mood Hamilton Anxiety Rating Scale - Anxious mood: worries, HAMA - Anxious Mood
anticipation of the worst, fearful anticipation, irritability.
C102074 HAMA102 HAMA1-Tension Hamilton Anxiety Rating Scale - Tension: feelings of HAMA - Tension
tension, fatigability, startle response, moved to tears
easily, trembling, feelings of restlessness, inability to
relax.
C102075 HAMA103 HAMA1-Fears Hamilton Anxiety Rating Scale - Fears: of dark, of HAMA - Fears
strangers, of being left alone, of animals, of traffic, of
crowds.
C102076 HAMA104 HAMA1-Insomnia Hamilton Anxiety Rating Scale - Insomnia: difficulty HAMA - Insomnia
falling asleep, broken sleep, unsatisfying sleep and
fatigue on waking, dreams, nightmares, night terrors.
C102077 HAMA105 HAMA1-Intellectual Hamilton Anxiety Rating Scale - Intellectual: difficulty in HAMA - Intellectual
concentration, poor memory.
C102078 HAMA106 HAMA1-Depressed Mood Hamilton Anxiety Rating Scale - Depressed mood: loss of HAMA - Depressed Mood
interest, lack of pleasure in hobbies, depression, early
waking, diurnal swing.
C102079 HAMA107 HAMA1-Somatic Hamilton Anxiety Rating Scale - Somatic (muscular): HAMA - Somatic
(Muscular) pains and aches, twitching, stiffness, myoclonic jerks, (Muscular)
grinding of teeth, unsteady voice, increased muscular
tone.
C102080 HAMA108 HAMA1-Somatic Hamilton Anxiety Rating Scale - Somatic (sensory): HAMA - Somatic
(Sensory) tinnitus, blurring of vision, hot and cold flushes, feelings (Sensory)
of weakness, pricking sensation.
C102081 HAMA109 HAMA1-Cardiovascular Hamilton Anxiety Rating Scale - Cardiovascular HAMA - Cardiovascular
Symptoms symptoms: tachycardia, palpitations, pain in chest, Symptoms
throbbing of vessels, fainting feelings, missing beat.
C102082 HAMA110 HAMA1-Respiratory Hamilton Anxiety Rating Scale - Respiratory symptoms: HAMA - Respiratory
Symptoms pressure or constriction in chest, choking feelings, Symptoms
sighing, dyspnea.
C102083 HAMA111 HAMA1-Gastrointestinal Hamilton Anxiety Rating Scale - Gastrointestinal HAMA - Gastrointestinal
Symptoms symptoms: difficulty swallowing, wind abdominal pain, Symptoms
burning sensations, abdominal fullness, nausea, vomiting,
borborygmi, looseness of bowels, loss of weight,
constipation.
C102084 HAMA112 HAMA1-Genitourinary Hamilton Anxiety Rating Scale - Genitourinary symptoms: HAMA - Genitourinary
Symptoms frequency of micturition, urgency of micturition, Symptoms
amenorrhea, menorrhagia, development of frigidity,
premature ejaculation, loss of libido, impotence.
C102085 HAMA113 HAMA1-Autonomic Hamilton Anxiety Rating Scale - Autonomic symptoms: HAMA - Autonomic
Symptoms dry mouth, flushing, pallor, tendency to sweat, giddiness, Symptoms
tension, headache, raising of hair.
C102086 HAMA114 HAMA1-Behavior at Hamilton Anxiety Rating Scale - Behavior at interview: HAMA - Behavior at
Interview fidgeting, restlessness or pacing, tremor of hands, Interview
furrowed brow, strained face, sighing or rapid respiration,
facial pallor, swallowing, etc.
C155646 HAMA115 HAMA1-Total Score Hamilton Anxiety Rating Scale - Total score. HAMA - Total Score
page 671 of 1925

HAMA1TN (Hamilton Anxiety Rating Scale Clinical Classification Test Name)
C101820 HAMA1TN
Code Value
C102073 HAMA1-Anxious Mood HAMA1-Anxious Mood Hamilton Anxiety Rating Scale - Anxious mood: worries, HAMA - Anxious Mood
anticipation of the worst, fearful anticipation, irritability.
C102085 HAMA1-Autonomic HAMA1-Autonomic Hamilton Anxiety Rating Scale - Autonomic symptoms: HAMA - Autonomic
Symptoms Symptoms dry mouth, flushing, pallor, tendency to sweat, giddiness, Symptoms
tension, headache, raising of hair.
C102086 HAMA1-Behavior at HAMA1-Behavior at Hamilton Anxiety Rating Scale - Behavior at interview: HAMA - Behavior at
Interview Interview fidgeting, restlessness or pacing, tremor of hands, Interview
furrowed brow, strained face, sighing or rapid respiration,
facial pallor, swallowing, etc.
C102081 HAMA1-Cardiovascular HAMA1-Cardiovascular Hamilton Anxiety Rating Scale - Cardiovascular HAMA - Cardiovascular
Symptoms Symptoms symptoms: tachycardia, palpitations, pain in chest, Symptoms
throbbing of vessels, fainting feelings, missing beat.
C102078 HAMA1-Depressed Mood HAMA1-Depressed Mood Hamilton Anxiety Rating Scale - Depressed mood: loss of HAMA - Depressed Mood
interest, lack of pleasure in hobbies, depression, early
waking, diurnal swing.
C102075 HAMA1-Fears HAMA1-Fears Hamilton Anxiety Rating Scale - Fears: of dark, of HAMA - Fears
strangers, of being left alone, of animals, of traffic, of
crowds.
C102083 HAMA1-Gastrointestinal HAMA1-Gastrointestinal Hamilton Anxiety Rating Scale - Gastrointestinal HAMA - Gastrointestinal
Symptoms Symptoms symptoms: difficulty swallowing, wind abdominal pain, Symptoms
burning sensations, abdominal fullness, nausea, vomiting,
borborygmi, looseness of bowels, loss of weight,
constipation.
C102084 HAMA1-Genitourinary HAMA1-Genitourinary Hamilton Anxiety Rating Scale - Genitourinary symptoms: HAMA - Genitourinary
Symptoms Symptoms frequency of micturition, urgency of micturition, Symptoms
amenorrhea, menorrhagia, development of frigidity,
premature ejaculation, loss of libido, impotence.
C102076 HAMA1-Insomnia HAMA1-Insomnia Hamilton Anxiety Rating Scale - Insomnia: difficulty HAMA - Insomnia
falling asleep, broken sleep, unsatisfying sleep and
fatigue on waking, dreams, nightmares, night terrors.
C102077 HAMA1-Intellectual HAMA1-Intellectual Hamilton Anxiety Rating Scale - Intellectual: difficulty in HAMA - Intellectual
concentration, poor memory.
C102082 HAMA1-Respiratory HAMA1-Respiratory Hamilton Anxiety Rating Scale - Respiratory symptoms: HAMA - Respiratory
Symptoms Symptoms pressure or constriction in chest, choking feelings, Symptoms
sighing, dyspnea.
C102079 HAMA1-Somatic HAMA1-Somatic Hamilton Anxiety Rating Scale - Somatic (muscular): HAMA - Somatic
(Muscular) (Muscular) pains and aches, twitching, stiffness, myoclonic jerks, (Muscular)
grinding of teeth, unsteady voice, increased muscular
tone.
C102080 HAMA1-Somatic HAMA1-Somatic Hamilton Anxiety Rating Scale - Somatic (sensory): HAMA - Somatic
(Sensory) (Sensory) tinnitus, blurring of vision, hot and cold flushes, feelings (Sensory)
of weakness, pricking sensation.
C102074 HAMA1-Tension HAMA1-Tension Hamilton Anxiety Rating Scale - Tension: feelings of HAMA - Tension
tension, fatigability, startle response, moved to tears
easily, trembling, feelings of restlessness, inability to
relax.
C155646 HAMA1-Total Score HAMA1-Total Score Hamilton Anxiety Rating Scale - Total score. HAMA - Total Score
page 672 of 1925

HAMD1TC (Hamilton Depression Rating Scale - 17 Item Clinical Classification Test Code)
C100138 HAMD1TC
Code Value
C100398 HAMD101 HAMD1-Depressed Mood Hamilton Depression Rating Scale 17 Item - Depressed HAMD-17 - Depressed
mood: sadness, hopeless, helpless, worthless. Mood
C100399 HAMD102 HAMD1-Feelings of Guilt Hamilton Depression Rating Scale 17 Item - Feelings of HAMD-17 - Feelings of
guilt. Guilt
C100400 HAMD103 HAMD1-Suicide Hamilton Depression Rating Scale 17 Item - Suicide. HAMD-17 - Suicide
C100401 HAMD104 HAMD1-Insomnia Early - Hamilton Depression Rating Scale 17 Item - Insomnia: HAMD-17 - Insomnia -
Early Night early in the night. Early Night
C100402 HAMD105 HAMD1-Insomnia Middle - Hamilton Depression Rating Scale 17 Item - Insomnia: HAMD-17 - Insomnia -
Middle Night middle of the night. Middle Night
C100403 HAMD106 HAMD1-Insomnia Early Hamilton Depression Rating Scale 17 Item - Insomnia: HAMD-17 - Insomnia -
Hours - Morning early hours of the morning. Early Morning
C100404 HAMD107 HAMD1-Work and Hamilton Depression Rating Scale 17 Item - Work and HAMD-17 - Work and
Activities activities. Activities
C100405 HAMD108 HAMD1-Retardation Hamilton Depression Rating Scale 17 Item - Retardation. HAMD-17 - Retardation
C100406 HAMD109 HAMD1-Agitation Hamilton Depression Rating Scale 17 Item - Agitation. HAMD-17 - Agitation
C100407 HAMD110 HAMD1-Anxiety Psychic Hamilton Depression Rating Scale 17 Item - Anxiety HAMD-17 - Psychic
psychic. Anxiety
C100408 HAMD111 HAMD1-Anxiety Somatic Hamilton Depression Rating Scale 17 Item - Anxiety HAMD-17 - Somatic
somatic: physiological concomitants of anxiety such as Anxiety
gastro-intestinal (dry mouth, wind, indigestion, diarrhea,
cramps, belching), cardiovascular (palpitations,
headaches), respiratory (hyperventilation, sighing),
urinary frequency, sweating.
C100409 HAMD112 HAMD1-Somatic Hamilton Depression Rating Scale 17 Item - Somatic HAMD-17 -
Symptoms GI symptoms gastro-intestinal. Gastrointestinal Somatic
Symptoms
C100410 HAMD113 HAMD1-General Somatic Hamilton Depression Rating Scale 17 Item - General HAMD-17 - General
Symptoms somatic symptoms. Somatic Symptoms
C100411 HAMD114 HAMD1-Genital Hamilton Depression Rating Scale 17 Item - Genital HAMD-17 - Genital
Symptoms symptoms: symptoms such as loss of libido, menstrual Symptoms
disturbances.
C100412 HAMD115 HAMD1-Hypochondriasis Hamilton Depression Rating Scale 17 Item - HAMD-17 -

Hypochondriasis. Hypochondriasis
C100413 HAMD116A HAMD1-Loss of WT Hamilton Depression Rating Scale 17 Item - Loss of HAMD-17 - Loss of
According to Patient weight according to the patient. Weight According to
Patient
C100414 HAMD116B HAMD1-Loss of WT Hamilton Depression Rating Scale 17 Item - Loss of HAMD-17 - Loss of
According to WK Meas weight according to weekly measurements. Weight According to
Weekly Measurements
C100415 HAMD117 HAMD1-Insight Hamilton Depression Rating Scale 17 Item - Insight. HAMD-17 - Insight
C100416 HAMD118 HAMD1-Total Score Hamilton Depression Rating Scale 17 Item - Total Score. HAMD-17 - Total Score
page 673 of 1925

HAMD1TN (Hamilton Depression Rating Scale - 17 Item Clinical Classification Test Name)
C100137 HAMD1TN
Code Value
C100406 HAMD1-Agitation HAMD1-Agitation Hamilton Depression Rating Scale 17 Item - Agitation. HAMD-17 - Agitation
C100407 HAMD1-Anxiety Psychic HAMD1-Anxiety Psychic Hamilton Depression Rating Scale 17 Item - Anxiety HAMD-17 - Psychic
psychic. Anxiety
C100408 HAMD1-Anxiety Somatic HAMD1-Anxiety Somatic Hamilton Depression Rating Scale 17 Item - Anxiety HAMD-17 - Somatic
somatic: physiological concomitants of anxiety such as Anxiety
gastro-intestinal (dry mouth, wind, indigestion, diarrhea,
cramps, belching), cardiovascular (palpitations,
headaches), respiratory (hyperventilation, sighing),
urinary frequency, sweating.
C100398 HAMD1-Depressed Mood HAMD1-Depressed Mood Hamilton Depression Rating Scale 17 Item - Depressed HAMD-17 - Depressed
mood: sadness, hopeless, helpless, worthless. Mood
C100399 HAMD1-Feelings of Guilt HAMD1-Feelings of Guilt Hamilton Depression Rating Scale 17 Item - Feelings of HAMD-17 - Feelings of
guilt. Guilt
C100410 HAMD1-General Somatic HAMD1-General Somatic Hamilton Depression Rating Scale 17 Item - General HAMD-17 - General
Symptoms Symptoms somatic symptoms. Somatic Symptoms
C100411 HAMD1-Genital HAMD1-Genital Hamilton Depression Rating Scale 17 Item - Genital HAMD-17 - Genital
Symptoms Symptoms symptoms: symptoms such as loss of libido, menstrual Symptoms
disturbances.
C100412 HAMD1-Hypochondriasis HAMD1-Hypochondriasis Hamilton Depression Rating Scale 17 Item - HAMD-17 -

C100415 HAMD1-Insight HAMD1-Insight Hamilton Depression Rating Scale 17 Item - Insight. HAMD-17 - Insight
C100401 HAMD1-Insomnia Early - HAMD1-Insomnia Early - Hamilton Depression Rating Scale 17 Item - Insomnia: HAMD-17 - Insomnia -
Early Night Early Night early in the night. Early Night
C100403 HAMD1-Insomnia Early HAMD1-Insomnia Early Hamilton Depression Rating Scale 17 Item - Insomnia: HAMD-17 - Insomnia -
Hours - Morning Hours - Morning early hours of the morning. Early Morning
C100402 HAMD1-Insomnia Middle - HAMD1-Insomnia Middle - Hamilton Depression Rating Scale 17 Item - Insomnia: HAMD-17 - Insomnia -
Middle Night Middle Night middle of the night. Middle Night
C100413 HAMD1-Loss of WT HAMD1-Loss of WT Hamilton Depression Rating Scale 17 Item - Loss of HAMD-17 - Loss of
According to Patient According to Patient weight according to the patient. Weight According to
Patient
C100414 HAMD1-Loss of WT HAMD1-Loss of WT Hamilton Depression Rating Scale 17 Item - Loss of HAMD-17 - Loss of
According to WK Meas According to WK Meas weight according to weekly measurements. Weight According to
Weekly Measurements
C100405 HAMD1-Retardation HAMD1-Retardation Hamilton Depression Rating Scale 17 Item - Retardation. HAMD-17 - Retardation
C100409 HAMD1-Somatic HAMD1-Somatic Hamilton Depression Rating Scale 17 Item - Somatic HAMD-17 -
Symptoms GI Symptoms GI symptoms gastro-intestinal. Gastrointestinal Somatic
Symptoms
C100400 HAMD1-Suicide HAMD1-Suicide Hamilton Depression Rating Scale 17 Item - Suicide. HAMD-17 - Suicide
C100416 HAMD1-Total Score HAMD1-Total Score Hamilton Depression Rating Scale 17 Item - Total Score. HAMD-17 - Total Score
C100404 HAMD1-Work and HAMD1-Work and Hamilton Depression Rating Scale 17 Item - Work and HAMD-17 - Work and
Activities Activities activities. Activities
page 674 of 1925

HAMD2TC (Hamilton Depression Rating Scale 21-Item Clinical Classification Test Code)
C101821 HAMD2TC
Code Value
C102087 HAMD201 HAMD2-Depressed Mood Hamilton Depression Rating Scale 21 Item - HAMD-21 - Depressed
Depressed mood: sadness, hopeless, helpless, Mood
worthless.
C102088 HAMD202 HAMD2-Feelings of Guilt Hamilton Depression Rating Scale 21 Item - HAMD-21 - Feelings of
Feelings of guilt. Guilt
C102089 HAMD203 HAMD2-Suicide Hamilton Depression Rating Scale 21 Item - HAMD-21 - Suicide
Suicide.
C102090 HAMD204 HAMD2-Insomnia Early Hamilton Depression Rating Scale 21 Item - HAMD-21 - Insomnia
Insomnia early. Early
C102091 HAMD205 HAMD2-Insomnia Middle Hamilton Depression Rating Scale 21 Item - HAMD-21 - Insomnia
Insomnia middle. Middle
C102092 HAMD206 HAMD2-Insomnia Late Hamilton Depression Rating Scale 21 Item - HAMD-21 - Insomnia Late
Insomnia late.
C102093 HAMD207 HAMD2-Work and Activities Hamilton Depression Rating Scale 21 Item - HAMD-21 - Work and
Work and activities. Activities
C102094 HAMD208 HAMD2-Retardation Hamilton Depression Rating Scale 21 Item - HAMD-21 - Retardation
Retardation: psychomotor (slowness of thought
and speech; impaired ability to concentrate;
decreased motor activity).
C102095 HAMD209 HAMD2-Agitation Hamilton Depression Rating Scale 21 Item - HAMD-21 - Agitation
Agitation.
C102096 HAMD210 HAMD2-Anxiety Psychological Hamilton Depression Rating Scale 21 Item - HAMD-21 - Anxiety
Anxiety Psychological. Psychological
C102097 HAMD211 HAMD2-Anxiety Somatic Hamilton Depression Rating Scale 21 Item - HAMD-21 - Anxiety
Anxiety somatic: physiological concomitants of Somatic
anxiety, (i.e., effects of autonomic overactivity,
'butterflies,' indigestion, stomach cramps,
belching, diarrhea, palpitations, hyperventilation,
paresthesia, sweating, flushing, tremor,
headache, urinary frequency).
C102098 HAMD212 HAMD2-Somatic Symptoms Hamilton Depression Rating Scale 21 Item - HAMD-21 - Somatic
Gastro-intestinal Somatic symptoms gastro-intestinal. Symptoms Gastro-
intestinal
C102099 HAMD213 HAMD2-Somatic Symptoms Hamilton Depression Rating Scale 21 Item - HAMD-21 - Somatic
General Somatic symptoms general. Symptoms General
C102100 HAMD214 HAMD2-Genital Symptoms Hamilton Depression Rating Scale 21 Item - HAMD-21 - Genital
Genital symptoms: symptoms such as: loss of Symptoms
libido; impaired sexual performance; menstrual
disturbances.
C102101 HAMD215 HAMD2-Hypochondriasis Hamilton Depression Rating Scale 21 Item - HAMD-21 -

C102102 HAMD216A HAMD2-Loss of Weight by History Hamilton Depression Rating Scale 21 Item - Loss HAMD-21 - Loss of
of weight when rating by history. Weight by History
C102103 HAMD216B HAMD2-Loss of Weight Measured Hamilton Depression Rating Scale 21 Item - Loss HAMD-21 - Loss of
of weight on weekly ratings by war psychiatrist, Weight Measured
when actual weight changes are measured.
C102104 HAMD217 HAMD2-Insight Hamilton Depression Rating Scale 21 Item - HAMD-21 - Insight
Insight.
C102105 HAMD218A HAMD2-Diurnal Variation Hamilton Depression Rating Scale 21 Item - HAMD-21 - Diurnal
Diurnal variation. Variation
C102106 HAMD218B HAMD2-Diurnal Variation Severity Hamilton Depression Rating Scale 21 Item - HAMD-21 - Diurnal
Diurnal variation severity. Variation Severity
C102107 HAMD219 HAMD2- Hamilton Depression Rating Scale 21 Item - HAMD-21 -

Depersonalization/Derealization Depersonalization and derealization: such as Depersonalization and
feelings of unreality; nihilistic ideas. Derealization
C102108 HAMD220 HAMD2-Paranoid Symptoms Hamilton Depression Rating Scale 21 Item - HAMD-21 - Paranoid
Paranoid symptoms. Symptoms
page 675 of 1925

C101821 HAMD2TC
Code Value
C102109 HAMD221 HAMD2-Obsessional/Compulsive Hamilton Depression Rating Scale 21 Item - HAMD-21 - Obsessional
Symptoms Obsessional and compulsive symptoms. and Compulsive
Symptoms
C102110 HAMD222 HAMD2-Total Score Hamilton Depression Rating Scale 21 Item - HAMD-21 - Total Score
Total score.
page 676 of 1925

HAMD2TN (Hamilton Depression Rating Scale 21-Item Clinical Classification Test Name)
C101822 HAMD2TN
Code
C102095 HAMD2-Agitation HAMD2-Agitation Hamilton Depression Rating Scale 21 HAMD-21 - Agitation

Item - Agitation.
C102096 HAMD2-Anxiety Psychological HAMD2-Anxiety Psychological Hamilton Depression Rating Scale 21 HAMD-21 - Anxiety
Item - Anxiety Psychological. Psychological
C102097 HAMD2-Anxiety Somatic HAMD2-Anxiety Somatic Hamilton Depression Rating Scale 21 HAMD-21 - Anxiety
Item - Anxiety somatic: physiological Somatic
concomitants of anxiety, (i.e., effects of
autonomic overactivity, 'butterflies,'
indigestion, stomach cramps, belching,
diarrhea, palpitations, hyperventilation,
paresthesia, sweating, flushing, tremor,
headache, urinary frequency).
C102107 HAMD2- HAMD2- Hamilton Depression Rating Scale 21 HAMD-21 -

Depersonalization/Derealization Depersonalization/Derealization Item - Depersonalization and Depersonalization and
derealization: such as feelings of Derealization
unreality; nihilistic ideas.
C102087 HAMD2-Depressed Mood HAMD2-Depressed Mood Hamilton Depression Rating Scale 21 HAMD-21 - Depressed
Item - Depressed mood: sadness, Mood
hopeless, helpless, worthless.
C102105 HAMD2-Diurnal Variation HAMD2-Diurnal Variation Hamilton Depression Rating Scale 21 HAMD-21 - Diurnal
Item - Diurnal variation. Variation
C102106 HAMD2-Diurnal Variation Severity HAMD2-Diurnal Variation Severity Hamilton Depression Rating Scale 21 HAMD-21 - Diurnal
Item - Diurnal variation severity. Variation Severity
C102088 HAMD2-Feelings of Guilt HAMD2-Feelings of Guilt Hamilton Depression Rating Scale 21 HAMD-21 - Feelings of
Item - Feelings of guilt. Guilt
C102100 HAMD2-Genital Symptoms HAMD2-Genital Symptoms Hamilton Depression Rating Scale 21 HAMD-21 - Genital
Item - Genital symptoms: symptoms Symptoms
such as: loss of libido; impaired sexual
performance; menstrual disturbances.
C102101 HAMD2-Hypochondriasis HAMD2-Hypochondriasis Hamilton Depression Rating Scale 21 HAMD-21 -

Item - Hypochondriasis. Hypochondriasis
C102104 HAMD2-Insight HAMD2-Insight Hamilton Depression Rating Scale 21 HAMD-21 - Insight

Item - Insight.
C102090 HAMD2-Insomnia Early HAMD2-Insomnia Early Hamilton Depression Rating Scale 21 HAMD-21 - Insomnia
Item - Insomnia early. Early
C102092 HAMD2-Insomnia Late HAMD2-Insomnia Late Hamilton Depression Rating Scale 21 HAMD-21 - Insomnia Late
Item - Insomnia late.
C102091 HAMD2-Insomnia Middle HAMD2-Insomnia Middle Hamilton Depression Rating Scale 21 HAMD-21 - Insomnia
Item - Insomnia middle. Middle
C102102 HAMD2-Loss of Weight by History HAMD2-Loss of Weight by History Hamilton Depression Rating Scale 21 HAMD-21 - Loss of
Item - Loss of weight when rating by Weight by History
history.
C102103 HAMD2-Loss of Weight Measured HAMD2-Loss of Weight Measured Hamilton Depression Rating Scale 21 HAMD-21 - Loss of
Item - Loss of weight on weekly ratings Weight Measured
by war psychiatrist, when actual weight
changes are measured.
C102109 HAMD2-Obsessional/Compulsive HAMD2-Obsessional/Compulsive Hamilton Depression Rating Scale 21 HAMD-21 - Obsessional

Symptoms Symptoms Item - Obsessional and compulsive and Compulsive
symptoms. Symptoms
C102108 HAMD2-Paranoid Symptoms HAMD2-Paranoid Symptoms Hamilton Depression Rating Scale 21 HAMD-21 - Paranoid
Item - Paranoid symptoms. Symptoms
C102094 HAMD2-Retardation HAMD2-Retardation Hamilton Depression Rating Scale 21 HAMD-21 - Retardation

Item - Retardation: psychomotor
(slowness of thought and speech;
impaired ability to concentrate;
decreased motor activity).
C102098 HAMD2-Somatic Symptoms HAMD2-Somatic Symptoms Hamilton Depression Rating Scale 21 HAMD-21 - Somatic
Gastro-intestinal Gastro-intestinal Item - Somatic symptoms gastro- Symptoms Gastro-
intestinal. intestinal
page 677 of 1925

C101822 HAMD2TN
Code
C102099 HAMD2-Somatic Symptoms HAMD2-Somatic Symptoms Hamilton Depression Rating Scale 21 HAMD-21 - Somatic
General General Item - Somatic symptoms general. Symptoms General
C102089 HAMD2-Suicide HAMD2-Suicide Hamilton Depression Rating Scale 21 HAMD-21 - Suicide

Item - Suicide.
C102110 HAMD2-Total Score HAMD2-Total Score Hamilton Depression Rating Scale 21 HAMD-21 - Total Score
Item - Total score.
C102093 HAMD2-Work and Activities HAMD2-Work and Activities Hamilton Depression Rating Scale 21 HAMD-21 - Work and
Item - Work and activities. Activities
page 678 of 1925

HAMD3TC (Hamilton Depression Rating Scale - 24 Item Clinical Classification Test Code)
C130245 HAMD3TC
Code Value
C130335 HAMD301 HAMD3-Depressed Mood Hamilton Depression Rating Scale 24 Item - HAMD 24 - Depressed
Depressed mood. Mood
C130336 HAMD302 HAMD3-Low Self-Esteem, Guilt Hamilton Depression Rating Scale 24 Item - Low HAMD 24 - Low Self-
self-esteem, guilt. esteem, Guilt
C130337 HAMD303 HAMD3-Suicidal Thoughts Hamilton Depression Rating Scale 24 Item - HAMD 24 - Suicidal
Suicidal thoughts. Thoughts
C130338 HAMD304 HAMD3-Insomnia - Initial Hamilton Depression Rating Scale 24 Item - HAMD 24 - Insomnia -
Insomnia - initial. Initial
C130339 HAMD305 HAMD3-Insomnia - Middle Hamilton Depression Rating Scale 24 Item - HAMD 24 - Insomnia -
Insomnia - middle. Middle
C130340 HAMD306 HAMD3-Insomnia - Late Hamilton Depression Rating Scale 24 Item - HAMD 24 - Insomnia -
Insomnia - late. Late
C130341 HAMD307 HAMD3-Work and Interests Hamilton Depression Rating Scale 24 Item - HAMD 24 - Work and
Work and interests. Interests
C130342 HAMD308 HAMD3-Psychomotor Retardation Hamilton Depression Rating Scale 24 Item - HAMD 24 - Psychomotor
Psychomotor retardation. Retardation
C130343 HAMD309 HAMD3-Psychomotor Agitation Hamilton Depression Rating Scale 24 Item - HAMD 24 - Psychomotor
Psychomotor agitation. Agitation
C130344 HAMD310 HAMD3-Anxiety - Psychic Hamilton Depression Rating Scale 24 Item - HAMD 24 - Anxiety,
Anxiety - psychic. Psychic
C130345 HAMD311 HAMD3-Anxiety - Somatic Hamilton Depression Rating Scale 24 Item - HAMD 24 - Anxiety,
Anxiety - somatic. Somatic
C130346 HAMD312 HAMD3-GI Symptoms (Appetite) Hamilton Depression Rating Scale 24 Item - HAMD 24 -
Gastrointestinal symptoms (appetite). Gastrointestinal
Symptoms (Appetite)
C130347 HAMD313 HAMD3-Somatic Symptoms - Hamilton Depression Rating Scale 24 Item - HAMD 24 - Somatic
General Somatic symptoms - general. Symptoms, General
C130348 HAMD314 HAMD3-Sexual Disturbances Hamilton Depression Rating Scale 24 Item - HAMD 24 - Sexual
Sexual disturbances. Disturbances
C130349 HAMD315 HAMD3-Hypochondriasis Hamilton Depression Rating Scale 24 Item - HAMD 24 -

(Somatisation) Hypochondriasis (somatisation). Hypochondriasis
(Somatisation)
C130350 HAMD316 HAMD3-Insight Hamilton Depression Rating Scale 24 Item - HAMD 24 - Insight
Insight.
C130351 HAMD317 HAMD3-Weight Loss Hamilton Depression Rating Scale 24 Item - HAMD 24 - Weight Loss
Weight loss.
C130352 HAMD318 HAMD3-Diurnal Variation Hamilton Depression Rating Scale 24 Item - HAMD 24 - Diurnal
Diurnal variation. Variation
C130353 HAMD319 HAMD3- Hamilton Depression Rating Scale 24 Item - HAMD 24 -

Depersonalization/Derealization Depersonalization/derealization. Depersonalization and
Derealisation
C130354 HAMD320 HAMD3-Paranoid Symptoms Hamilton Depression Rating Scale 24 Item - HAMD 24 - Paranoid
Paranoid symptoms. Symptoms
C130355 HAMD321 HAMD3-Observational/Compulsive Hamilton Depression Rating Scale 24 Item - HAMD 24 - Obsessional
Symptoms Observational/compulsive symptoms. and Compulsive
Symptoms
C130356 HAMD322 HAMD3-Helplessness Hamilton Depression Rating Scale 24 Item - HAMD 24 - Helplessness
Helplessness.
C130357 HAMD323 HAMD3-Hopelessness Hamilton Depression Rating Scale 24 Item - HAMD 24 - Hopelessness
Hopelessness.
C130358 HAMD324 HAMD3-Worthlessness Hamilton Depression Rating Scale 24 Item - HAMD 24 - Worthlessness
Worthlessness.
C130359 HAMD325 HAMD3-Total Score Hamilton Depression Rating Scale 24 Item - HAMD 24 - Total Score
Total score.
page 679 of 1925

HAMD3TN (Hamilton Depression Rating Scale - 24 Item Clinical Classification Test Name)
C130244 HAMD3TN
Code
C130344 HAMD3-Anxiety - Psychic HAMD3-Anxiety - Psychic Hamilton Depression Rating Scale 24 HAMD 24 - Anxiety,
Item - Anxiety - psychic. Psychic
C130345 HAMD3-Anxiety - Somatic HAMD3-Anxiety - Somatic Hamilton Depression Rating Scale 24 HAMD 24 - Anxiety,
Item - Anxiety - somatic. Somatic
C130353 HAMD3- HAMD3- Hamilton Depression Rating Scale 24 HAMD 24 -

Depersonalization/Derealization Depersonalization/Derealization Item - Depersonalization/derealization. Depersonalization and
Derealisation
C130335 HAMD3-Depressed Mood HAMD3-Depressed Mood Hamilton Depression Rating Scale 24 HAMD 24 - Depressed
Item - Depressed mood. Mood
C130352 HAMD3-Diurnal Variation HAMD3-Diurnal Variation Hamilton Depression Rating Scale 24 HAMD 24 - Diurnal
Item - Diurnal variation. Variation
C130346 HAMD3-GI Symptoms (Appetite) HAMD3-GI Symptoms (Appetite) Hamilton Depression Rating Scale 24 HAMD 24 -
Item - Gastrointestinal symptoms Gastrointestinal
(appetite). Symptoms (Appetite)
C130356 HAMD3-Helplessness HAMD3-Helplessness Hamilton Depression Rating Scale 24 HAMD 24 - Helplessness

Item - Helplessness.
C130357 HAMD3-Hopelessness HAMD3-Hopelessness Hamilton Depression Rating Scale 24 HAMD 24 - Hopelessness

Item - Hopelessness.
C130349 HAMD3-Hypochondriasis HAMD3-Hypochondriasis Hamilton Depression Rating Scale 24 HAMD 24 -

(Somatisation) (Somatisation) Item - Hypochondriasis (somatisation). Hypochondriasis
(Somatisation)
C130350 HAMD3-Insight HAMD3-Insight Hamilton Depression Rating Scale 24 HAMD 24 - Insight

Item - Insight.
C130338 HAMD3-Insomnia - Initial HAMD3-Insomnia - Initial Hamilton Depression Rating Scale 24 HAMD 24 - Insomnia -
Item - Insomnia - initial. Initial
C130340 HAMD3-Insomnia - Late HAMD3-Insomnia - Late Hamilton Depression Rating Scale 24 HAMD 24 - Insomnia -
Item - Insomnia - late. Late
C130339 HAMD3-Insomnia - Middle HAMD3-Insomnia - Middle Hamilton Depression Rating Scale 24 HAMD 24 - Insomnia -
Item - Insomnia - middle. Middle
C130336 HAMD3-Low Self-Esteem, Guilt HAMD3-Low Self-Esteem, Guilt Hamilton Depression Rating Scale 24 HAMD 24 - Low Self-
Item - Low self-esteem, guilt. esteem, Guilt
C130355 HAMD3-Observational/Compulsive HAMD3-Observational/Compulsive Hamilton Depression Rating Scale 24 HAMD 24 - Obsessional

Symptoms Symptoms Item - Observational/compulsive and Compulsive
symptoms. Symptoms
C130354 HAMD3-Paranoid Symptoms HAMD3-Paranoid Symptoms Hamilton Depression Rating Scale 24 HAMD 24 - Paranoid
Item - Paranoid symptoms. Symptoms
C130343 HAMD3-Psychomotor Agitation HAMD3-Psychomotor Agitation Hamilton Depression Rating Scale 24 HAMD 24 - Psychomotor
Item - Psychomotor agitation. Agitation
C130342 HAMD3-Psychomotor Retardation HAMD3-Psychomotor Retardation Hamilton Depression Rating Scale 24 HAMD 24 - Psychomotor
Item - Psychomotor retardation. Retardation
C130348 HAMD3-Sexual Disturbances HAMD3-Sexual Disturbances Hamilton Depression Rating Scale 24 HAMD 24 - Sexual
Item - Sexual disturbances. Disturbances
C130347 HAMD3-Somatic Symptoms - HAMD3-Somatic Symptoms - Hamilton Depression Rating Scale 24 HAMD 24 - Somatic
General General Item - Somatic symptoms - general. Symptoms, General
C130337 HAMD3-Suicidal Thoughts HAMD3-Suicidal Thoughts Hamilton Depression Rating Scale 24 HAMD 24 - Suicidal
Item - Suicidal thoughts. Thoughts
C130359 HAMD3-Total Score HAMD3-Total Score Hamilton Depression Rating Scale 24 HAMD 24 - Total Score
Item - Total score.
C130351 HAMD3-Weight Loss HAMD3-Weight Loss Hamilton Depression Rating Scale 24 HAMD 24 - Weight Loss
Item - Weight loss.
C130341 HAMD3-Work and Interests HAMD3-Work and Interests Hamilton Depression Rating Scale 24 HAMD 24 - Work and
Item - Work and interests. Interests
C130358 HAMD3-Worthlessness HAMD3-Worthlessness Hamilton Depression Rating Scale 24 HAMD 24 - Worthlessness

Item - Worthlessness.
page 680 of 1925

HAMD4TC (Hamilton Depression Rating Scale - 6 Clinician Version Clinical Classification Test Code)
C130243 HAMD4TC
Code Value
C130328 HAMD401 HAMD4-Depressed Mood The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Version - Depressed mood. Version - Depressed Mood
C130329 HAMD402 HAMD4-Low Self-esteem The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
and Guilt Version - Low self-esteem and guilt. Version - Low Self-
esteem and Guilt
C130330 HAMD403 HAMD4-Social Life The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Activities/Interests Version - Social life activities and interests. Version - Social Life
Activities or Interests
C130331 HAMD404 HAMD4-Psychomotor The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Retardation, General Version - Psychomotor retardation, general. Version - Psychomotor
Retardation, General
C130332 HAMD405 HAMD4-Psychic Anxiety The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Version - Psychic anxiety. Version - Psychic Anxiety
C130333 HAMD406 HAMD4-Tiredness and The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Pains Version - Tiredness and pains. Version - Tiredness and
Pains
C130334 HAMD407 HAMD4-Total Score The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Version - Total score. Version - Total Score
page 681 of 1925

HAMD4TN (Hamilton Depression Rating Scale - 6 Clinician Version Clinical Classification Test Name)
C130242 HAMD4TN
Code Value
C130328 HAMD4-Depressed Mood HAMD4-Depressed Mood The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Version - Depressed mood. Version - Depressed Mood
C130329 HAMD4-Low Self-esteem HAMD4-Low Self-esteem The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
and Guilt and Guilt Version - Low self-esteem and guilt. Version - Low Self-
esteem and Guilt
C130332 HAMD4-Psychic Anxiety HAMD4-Psychic Anxiety The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Version - Psychic anxiety. Version - Psychic Anxiety
C130331 HAMD4-Psychomotor HAMD4-Psychomotor The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Retardation, General Retardation, General Version - Psychomotor retardation, general. Version - Psychomotor
Retardation, General
C130330 HAMD4-Social Life HAMD4-Social Life The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Activities/Interests Activities/Interests Version - Social life activities and interests. Version - Social Life
Activities or Interests
C130333 HAMD4-Tiredness and HAMD4-Tiredness and The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Pains Pains Version - Tiredness and pains. Version - Tiredness and
Pains
C130334 HAMD4-Total Score HAMD4-Total Score The Hamilton Depression Rating Scale 6 - Clinician HAM-D6 - Clinician
Version - Total score. Version - Total Score
page 682 of 1925

HAMDS1TC (Hamilton Depression Rating Scale - 6 Self-Report Questionnaire Test Code)
C130259 HAMDS1TC
Code Value
C130545 HAMDS101 HAMDS1-Depressed Mood Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
- (1)=Depressed mood per clinician version: How you Version - Depressed Mood
have been feeling over the past three days, including
today.
C130546 HAMDS102 HAMDS1-Low Self-esteem Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
and Guilt - (2)=Low self-esteem and guilt per clinician version: Version - Low Self-
How you have been feeling over the past three days, esteem and Guilt
including today.
C130547 HAMDS103 HAMDS1-Social Life Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
Activities/Interests - (3)=Social life activities and interests per clinician Version - Social Life
version: How you have been feeling over the past three Activities or Interests
days, including today.
C130548 HAMDS104 HAMDS1-Psychomotor Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
Retardation, General - (4)=Psychomotor retardation, general per clinician Version - Psychomotor
version: How you have been feeling over the past three Retardation
C130549 HAMDS105 HAMDS1-Psychic Anxiety Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
- (5)=Psychic anxiety per clinician version: How you have Version - Psychic Anxiety
been feeling over the past three days, including today.
C130550 HAMDS106 HAMDS1-Tiredness and Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
Pains - (6)=Tiredness and pains per clinician version: How you Version - Tiredness and
have been feeling over the past three days, including Pains
today.
page 683 of 1925

HAMDS1TN (Hamilton Depression Rating Scale - 6 Self-Report Questionnaire Test Name)
C130258 HAMDS1TN
Code Value
C130545 HAMDS1-Depressed Mood HAMDS1-Depressed Mood Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
- (1)=Depressed mood per clinician version: How you Version - Depressed Mood
have been feeling over the past three days, including
today.
C130546 HAMDS1-Low Self-esteem HAMDS1-Low Self-esteem Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
and Guilt and Guilt - (2)=Low self-esteem and guilt per clinician version: Version - Low Self-
How you have been feeling over the past three days, esteem and Guilt
including today.
C130549 HAMDS1-Psychic Anxiety HAMDS1-Psychic Anxiety Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
- (5)=Psychic anxiety per clinician version: How you have Version - Psychic Anxiety
been feeling over the past three days, including today.
C130548 HAMDS1-Psychomotor HAMDS1-Psychomotor Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
Retardation, General Retardation, General - (4)=Psychomotor retardation, general per clinician Version - Psychomotor
version: How you have been feeling over the past three Retardation
C130547 HAMDS1-Social Life HAMDS1-Social Life Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
Activities/Interests Activities/Interests - (3)=Social life activities and interests per clinician Version - Social Life
version: How you have been feeling over the past three Activities or Interests
C130550 HAMDS1-Tiredness and HAMDS1-Tiredness and Hamilton Depression Rating Scale 6 - Self-Report Version HAM-D6 Self-Report
Pains Pains - (6)=Tiredness and pains per clinician version: How you Version - Tiredness and
have been feeling over the past three days, including Pains
today.
page 684 of 1925

HAQ01TC (Health Assessment Questionnaire Disability Index With Pain Visual Analog Scale
C106667 HAQ01TC
Code Value
C106809 HAQ0101 HAQ01-Dress Yourself Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Dressing & Grooming: Are Dress Yourself
you able to dress yourself, including tying shoelaces
and doing buttons?
C106810 HAQ0102 HAQ01-Shampoo Your Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Hair Pain Visual Analog Scale - Dressing & Grooming: Are Shampoo Hair
you able to shampoo your hair?
C106811 HAQ0103 HAQ01-Stand Up From a Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Straight Chair Pain Visual Analog Scale - Arising: Are you able to Stand Up From Chair
stand up from a straight chair?
C106812 HAQ0104 HAQ01-Get In and Out of Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Bed Pain Visual Analog Scale - Arising: Are you able to get Get In and Out of Bed
in and out of bed?
C106813 HAQ0105 HAQ01-Cut Your Meat Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Eating: Are you able to cut Cut Meat
your meat?
C106814 HAQ0106 HAQ01-Lift a Full Cup or Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Glass to Mouth Pain Visual Analog Scale - Eating: Are you able to lift a Lift Cup or Glass to Mouth
full cup or glass to your mouth?
C106815 HAQ0107 HAQ01-Open a New Milk Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Carton Pain Visual Analog Scale - Eating: Are you able to open Open Milk Carton
a new milk carton?
C106816 HAQ0108 HAQ01-Walk Outdoors on Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Flat Ground Pain Visual Analog Scale - Walking: Are you able to Walk Outdoors On Flat
walk outdoors on flat ground? Ground
C106817 HAQ0109 HAQ01-Climb Up Five Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Steps Pain Visual Analog Scale - Walking: Are you able to Climb Up Steps
climb up five steps?
C106818 HAQ0110 HAQ01-Aid: Cane Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Cane
usually use for any of these activities: Cane.
C106819 HAQ0111 HAQ01-Aid: Walker Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Walker
usually use for any of these activities: Walker.
C106820 HAQ0112 HAQ01-Aid: Crutches Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Crutches
usually use for any of these activities: Crutches.
C106821 HAQ0113 HAQ01-Aid: Wheelchair Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Wheelchair
usually use for any of these activities: Wheelchair.
C106822 HAQ0114 HAQ01-Aid: Devices Used Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
for Dressing Pain Visual Analog Scale - Aids or devices that you Devices - Used For Dressing
usually use for any of these activities: Devices used for
dressing (button hook, zipper pull, long-handled shoe
horn, etc.).
C106823 HAQ0115 HAQ01-Aid: Built Up or Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Special Utensils Pain Visual Analog Scale - Aids or devices that you Devices - Built Up or Special
usually use for any of these activities: Built up or Utensils
special utensils.
C106824 HAQ0116 HAQ01-Aid: Special or Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Built Up Chair Pain Visual Analog Scale - Aids or devices that you Devices - Special or Built Up
usually use for any of these activities: Special or built Chair
up chair.
C106825 HAQ0117 HAQ01-Othr Aid Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Dress/Arising/Eat/Walk) Pain Visual Analog Scale - Aids or devices that you Devices For
usually use for any of these activities: Other. Dress/Arising/Eat/Walk-
Other
C106826 HAQ0118 HAQ01-Spec Aid Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Dress/Arising/Eat/Walk) Pain Visual Analog Scale - Aids or devices that you Devices For
usually use for any of these activities: Other (specify). Dress/Arising/Eat/Walk-
Specify
page 685 of 1925

C106667 HAQ01TC
Code Value
C106827 HAQ0119 HAQ01-Help: Dressing Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
and Grooming Pain Visual Analog Scale - Usually need help from From Another Person -
another person: Dressing and grooming. Dressing and Grooming
C106828 HAQ0120 HAQ01-Help: Arising Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
Pain Visual Analog Scale - Usually need help from From Another Person -
another person: Arising. Arising
C106829 HAQ0121 HAQ01-Help: Eating Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Eating. Eating
C106830 HAQ0122 HAQ01-Help: Walking Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Walking. Walking
C106831 HAQ0123 HAQ01-Wash and Dry Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Your Body Pain Visual Analog Scale - Hygiene: Are you able to Wash and Dry Body
wash and dry your body?
C106832 HAQ0124 HAQ01-Take a Tub Bath Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Hygiene: Are you able to Take Tub Bath
take a tub bath?
C106833 HAQ0125 HAQ01-Get On and Off Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
The Toilet Pain Visual Analog Scale - Hygiene: Are you able to get Get On and Off Toilet
on and off the toilet?
C106834 HAQ0126 HAQ01-Reach-Get Down Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
5 Lb Obj Above Head Pain Visual Analog Scale - Reach: Are you able to reach Reach and Get Down Object
and get down a 5 pound object (such as a bag of From Above Head
sugar) from just above your head?
C106835 HAQ0127 HAQ01-Bend Down Pick Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Up Clothing - Floor Pain Visual Analog Scale - Reach: Are you able to bend Bend Down and Pick Up
down to pick up clothing from the floor? Clothing From Floor
C106836 HAQ0128 HAQ01-Open Car Doors Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Grip: Are you able to open Open Car Doors
car doors?
C106837 HAQ0129 HAQ01-Open Jars Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Previously Opened Pain Visual Analog Scale - Grip: Are you able to open Open Previously Opened
jars which have been previously opened? Jars
C106838 HAQ0130 HAQ01-Turn Faucets On Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
And Off Pain Visual Analog Scale - Grip: Are you able to turn Turn Faucets On and Off
faucets on and off?
C106839 HAQ0131 HAQ01-Run Errands and Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Shop Pain Visual Analog Scale - Activities: Are you able to Run Errands and Shop
run errands and shop?
C106840 HAQ0132 HAQ01-Get In and Out of Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
a Car Pain Visual Analog Scale - Activities: Are you able to Get In and Out of Car
get in and out of a car?
C106841 HAQ0133 HAQ01-Able to Do Chores Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Activities: Are you able to do Do Chores - Vacuuming or
chores such as vacuuming or yardwork? Yardwork
C106842 HAQ0134 HAQ01-Aid: Raised Toilet Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Seat Pain Visual Analog Scale - Aids or devices that you Devices - Raised Toilet Seat
usually use for any of these activities: Raised toilet
seat.
C106843 HAQ0135 HAQ01-Aid: Bathtub Seat Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Bathtub Seat
usually use for any of these activities: Bathtub seat.
C107020 HAQ0136 HAQ01-Aid: Jar Opener Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Previously Open) Pain Visual Analog Scale - Aids or devices that you Devices - Jar Opener (Jars
usually use for any of these activities: Jar opener (for Previously Opened)
jars previously opened).
C106844 HAQ0137 HAQ01-Aid: Bathtub Bar Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Bathtub Bar
usually use for any of these activities: Bathtub bar.
C106845 HAQ0138 HAQ01-Aid: Long- Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Handled Appl Reach Pain Visual Analog Scale - Aids or devices that you Devices - Long-Handled
usually use for any of these activities: Long-handled Appliances for Reach
appliances for reach.
page 686 of 1925

C106667 HAQ01TC
Code Value
C106846 HAQ0139 HAQ01-Aid: Long- Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Handled Appl Bathroom Pain Visual Analog Scale - Aids or devices that you Devices - Long-Handled
usually use for any of these activities: Long-handled Appliances in Bathroom
appliances in bathroom.
C107093 HAQ0140 HAQ01-Othr Aid Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Hygiene/Reach/Grip/Act) Pain Visual Analog Scale - Aids or devices that you Devices For
usually use for any of these activities: Other. Hygiene/Reach/Grip/Act-
Other
C107094 HAQ0141 HAQ01-Spec Aid Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Hygiene/Reach/Grip/Act) Pain Visual Analog Scale - Aids or devices that you Devices For
usually use for any of these activities: Other (specify). Hygiene/Reach/Grip/Act-
Specify
C106847 HAQ0142 HAQ01-Help: Hygiene Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Hygiene. Hygiene
C106848 HAQ0143 HAQ01-Help: Reach Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Reach. Reach
C106849 HAQ0144 HAQ01-Help: Gripping Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
and Opening Things Pain Visual Analog Scale - Usually need help from From Another Person -
another person: Gripping and opening things. Gripping and Opening
Things
C106850 HAQ0145 HAQ01-Help: Errands and Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
Chores Pain Visual Analog Scale - Usually need help from From Another Person -
another person: Errands and chores. Errands and Chores
C106851 HAQ0146 HAQ01-Severity of Pain Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Severity
Pain Visual Analog Scale - How much pain have you of Pain in the Past Week
had because of your illness in the past week?
page 687 of 1925

HAQ01TN (Health Assessment Questionnaire Disability Index With Pain Visual Analog Scale
C106666 HAQ01TN
Code Value
C106841 HAQ01-Able to Do Chores HAQ01-Able to Do Chores Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Activities: Are you able to do Do Chores - Vacuuming or
chores such as vacuuming or yardwork? Yardwork
C106844 HAQ01-Aid: Bathtub Bar HAQ01-Aid: Bathtub Bar Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Bathtub Bar
C106843 HAQ01-Aid: Bathtub Seat HAQ01-Aid: Bathtub Seat Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Bathtub Seat
C106823 HAQ01-Aid: Built Up or HAQ01-Aid: Built Up or Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Special Utensils Special Utensils Pain Visual Analog Scale - Aids or devices that you Devices - Built Up or Special
usually use for any of these activities: Built up or Utensils
special utensils.
C106818 HAQ01-Aid: Cane HAQ01-Aid: Cane Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Cane
C106820 HAQ01-Aid: Crutches HAQ01-Aid: Crutches Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Crutches
C106822 HAQ01-Aid: Devices Used HAQ01-Aid: Devices Used Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
for Dressing for Dressing Pain Visual Analog Scale - Aids or devices that you Devices - Used For Dressing
usually use for any of these activities: Devices used for
dressing (button hook, zipper pull, long-handled shoe
horn, etc.).
C107020 HAQ01-Aid: Jar Opener HAQ01-Aid: Jar Opener Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Previously Open) (Previously Open) Pain Visual Analog Scale - Aids or devices that you Devices - Jar Opener (Jars
usually use for any of these activities: Jar opener (for Previously Opened)
jars previously opened).
C106846 HAQ01-Aid: Long- HAQ01-Aid: Long- Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Handled Appl Bathroom Handled Appl Bathroom Pain Visual Analog Scale - Aids or devices that you Devices - Long-Handled
usually use for any of these activities: Long-handled Appliances in Bathroom
C106845 HAQ01-Aid: Long- HAQ01-Aid: Long- Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Handled Appl Reach Handled Appl Reach Pain Visual Analog Scale - Aids or devices that you Devices - Long-Handled
usually use for any of these activities: Long-handled Appliances for Reach
C106842 HAQ01-Aid: Raised Toilet HAQ01-Aid: Raised Toilet Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Seat Seat Pain Visual Analog Scale - Aids or devices that you Devices - Raised Toilet Seat
usually use for any of these activities: Raised toilet
seat.
C106824 HAQ01-Aid: Special or HAQ01-Aid: Special or Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Built Up Chair Built Up Chair Pain Visual Analog Scale - Aids or devices that you Devices - Special or Built Up
usually use for any of these activities: Special or built Chair
up chair.
C106819 HAQ01-Aid: Walker HAQ01-Aid: Walker Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Walker
C106821 HAQ01-Aid: Wheelchair HAQ01-Aid: Wheelchair Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
Pain Visual Analog Scale - Aids or devices that you Devices - Wheelchair
C106835 HAQ01-Bend Down Pick HAQ01-Bend Down Pick Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Up Clothing - Floor Up Clothing - Floor Pain Visual Analog Scale - Reach: Are you able to bend Bend Down and Pick Up
down to pick up clothing from the floor? Clothing From Floor
C106817 HAQ01-Climb Up Five HAQ01-Climb Up Five Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Steps Steps Pain Visual Analog Scale - Walking: Are you able to Climb Up Steps
climb up five steps?
C106813 HAQ01-Cut Your Meat HAQ01-Cut Your Meat Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Eating: Are you able to cut Cut Meat
your meat?
page 688 of 1925

C106666 HAQ01TN
Code Value
C106809 HAQ01-Dress Yourself HAQ01-Dress Yourself Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Dressing & Grooming: Are Dress Yourself
you able to dress yourself, including tying shoelaces
and doing buttons?
C106840 HAQ01-Get In and Out of HAQ01-Get In and Out of Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
a Car a Car Pain Visual Analog Scale - Activities: Are you able to Get In and Out of Car
get in and out of a car?
C106812 HAQ01-Get In and Out of HAQ01-Get In and Out of Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Bed Bed Pain Visual Analog Scale - Arising: Are you able to get Get In and Out of Bed
in and out of bed?
C106833 HAQ01-Get On and Off HAQ01-Get On and Off Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
The Toilet The Toilet Pain Visual Analog Scale - Hygiene: Are you able to get Get On and Off Toilet
C106828 HAQ01-Help: Arising HAQ01-Help: Arising Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Arising. Arising
C106827 HAQ01-Help: Dressing HAQ01-Help: Dressing Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
and Grooming and Grooming Pain Visual Analog Scale - Usually need help from From Another Person -
another person: Dressing and grooming. Dressing and Grooming
C106829 HAQ01-Help: Eating HAQ01-Help: Eating Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Eating. Eating
C106850 HAQ01-Help: Errands and HAQ01-Help: Errands and Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
Chores Chores Pain Visual Analog Scale - Usually need help from From Another Person -
another person: Errands and chores. Errands and Chores
C106849 HAQ01-Help: Gripping HAQ01-Help: Gripping Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
and Opening Things and Opening Things Pain Visual Analog Scale - Usually need help from From Another Person -
another person: Gripping and opening things. Gripping and Opening
Things
C106847 HAQ01-Help: Hygiene HAQ01-Help: Hygiene Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Hygiene. Hygiene
C106848 HAQ01-Help: Reach HAQ01-Help: Reach Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Reach. Reach
C106830 HAQ01-Help: Walking HAQ01-Help: Walking Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Help
another person: Walking. Walking
C106814 HAQ01-Lift a Full Cup or HAQ01-Lift a Full Cup or Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Glass to Mouth Glass to Mouth Pain Visual Analog Scale - Eating: Are you able to lift a Lift Cup or Glass to Mouth
full cup or glass to your mouth?
C106815 HAQ01-Open a New Milk HAQ01-Open a New Milk Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Carton Carton Pain Visual Analog Scale - Eating: Are you able to open Open Milk Carton
a new milk carton?
C106836 HAQ01-Open Car Doors HAQ01-Open Car Doors Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Grip: Are you able to open Open Car Doors
car doors?
C106837 HAQ01-Open Jars HAQ01-Open Jars Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Previously Opened Previously Opened Pain Visual Analog Scale - Grip: Are you able to open Open Previously Opened
jars which have been previously opened? Jars
C106825 HAQ01-Othr Aid HAQ01-Othr Aid Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Dress/Arising/Eat/Walk) (Dress/Arising/Eat/Walk) Pain Visual Analog Scale - Aids or devices that you Devices For
usually use for any of these activities: Other. Dress/Arising/Eat/Walk-
Other
C107093 HAQ01-Othr Aid HAQ01-Othr Aid Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Hygiene/Reach/Grip/Act) (Hygiene/Reach/Grip/Act) Pain Visual Analog Scale - Aids or devices that you Devices For
usually use for any of these activities: Other. Hygiene/Reach/Grip/Act-
Other
C106834 HAQ01-Reach-Get Down HAQ01-Reach-Get Down Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
5 Lb Obj Above Head 5 Lb Obj Above Head Pain Visual Analog Scale - Reach: Are you able to reach Reach and Get Down Object
and get down a 5 pound object (such as a bag of From Above Head
sugar) from just above your head?
C106839 HAQ01-Run Errands and HAQ01-Run Errands and Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Shop Shop Pain Visual Analog Scale - Activities: Are you able to Run Errands and Shop
run errands and shop?
page 689 of 1925

C106666 HAQ01TN
Code Value
C106851 HAQ01-Severity of Pain HAQ01-Severity of Pain Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Severity
Pain Visual Analog Scale - How much pain have you of Pain in the Past Week
had because of your illness in the past week?
C106810 HAQ01-Shampoo Your HAQ01-Shampoo Your Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Hair Hair Pain Visual Analog Scale - Dressing & Grooming: Are Shampoo Hair
you able to shampoo your hair?
C106826 HAQ01-Spec Aid HAQ01-Spec Aid Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Dress/Arising/Eat/Walk) (Dress/Arising/Eat/Walk) Pain Visual Analog Scale - Aids or devices that you Devices For
usually use for any of these activities: Other (specify). Dress/Arising/Eat/Walk-
Specify
C107094 HAQ01-Spec Aid HAQ01-Spec Aid Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Aids or
(Hygiene/Reach/Grip/Act) (Hygiene/Reach/Grip/Act) Pain Visual Analog Scale - Aids or devices that you Devices For
usually use for any of these activities: Other (specify). Hygiene/Reach/Grip/Act-
Specify
C106811 HAQ01-Stand Up From a HAQ01-Stand Up From a Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Straight Chair Straight Chair Pain Visual Analog Scale - Arising: Are you able to Stand Up From Chair
stand up from a straight chair?
C106832 HAQ01-Take a Tub Bath HAQ01-Take a Tub Bath Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Pain Visual Analog Scale - Hygiene: Are you able to Take Tub Bath
take a tub bath?
C106838 HAQ01-Turn Faucets On HAQ01-Turn Faucets On Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
And Off And Off Pain Visual Analog Scale - Grip: Are you able to turn Turn Faucets On and Off
faucets on and off?
C106816 HAQ01-Walk Outdoors on HAQ01-Walk Outdoors on Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Flat Ground Flat Ground Pain Visual Analog Scale - Walking: Are you able to Walk Outdoors On Flat
walk outdoors on flat ground? Ground
C106831 HAQ01-Wash and Dry HAQ01-Wash and Dry Health Assessment Questionnaire Disability Index With HAQ-DI With VAS - Able to
Your Body Your Body Pain Visual Analog Scale - Hygiene: Are you able to Wash and Dry Body
wash and dry your body?
page 690 of 1925

HAQ02TC (Health Assessment Questionnaire Disability Index Without Pain Visual Analog Scale
C132523 HAQ02TC
Code Value
C132573 HAQ0201 HAQ02-Dress Yourself Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Dressing & Grooming: Are you Dress Yourself
able to dress yourself, including tying shoelaces and
doing buttons?
C132574 HAQ0202 HAQ02-Shampoo Your Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Hair Pain Visual Analog Scale - Dressing & Grooming: Are you Shampoo Your Hair
able to shampoo your hair?
C132575 HAQ0203 HAQ02-Stand Up From a Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Straight Chair Pain Visual Analog Scale - Arising: Are you able to stand Stand Up From a Straight
up from a straight chair? Chair
C132576 HAQ0204 HAQ02-Get In and Out of Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Bed Pain Visual Analog Scale - Arising: Are you able to get in Get In and Out of Bed
and out of bed?
C132577 HAQ0205 HAQ02-Cut Your Meat Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Eating: Are you able to cut Cut Your Meat
your meat?
C132578 HAQ0206 HAQ02-Lift a Full Cup or Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Glass to Mouth Pain Visual Analog Scale - Eating: Are you able to lift a Lift a Full Cup or Glass to
full cup or glass to your mouth? Mouth
C132579 HAQ0207 HAQ02-Open a New Milk Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Carton Pain Visual Analog Scale - Eating: Are you able to open a Open a New Milk Carton
new milk carton?
C132580 HAQ0208 HAQ02-Walk Outdoors on Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Flat Ground Pain Visual Analog Scale - Walking: Are you able to walk Walk Outdoors on Flat
outdoors on flat ground? Ground
C132581 HAQ0209 HAQ02-Climb Up Five Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Steps Pain Visual Analog Scale - Walking: Are you able to climb Climb Up Five Steps
up five steps?
C132582 HAQ0210 HAQ02-Aid: Cane Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Cane
C132583 HAQ0211 HAQ02-Aid: Walker Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Walker
C132584 HAQ0212 HAQ02-Aid: Crutches Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Crutches
C132585 HAQ0213 HAQ02-Aid: Wheelchair Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Wheelchair
C132586 HAQ0214 HAQ02-Aid: Devices Used Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
for Dressing Pain Visual Analog Scale - Aids or devices that you Aid: Devices Used for
usually use for any of these activities: Devices used for Dressing
Dressing (button hook, zipper pull, long-handled shoe
horn, etc.).
C132587 HAQ0215 HAQ02-Aid: Built Up or Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Special Utensils Pain Visual Analog Scale - Aids or devices that you Aid: Built Up or Special
usually use for any of these activities: Built up or special Utensils
utensils.
C132588 HAQ0216 HAQ02-Aid: Special or Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Built Up Chair Pain Visual Analog Scale - Aids or devices that you Aid: Special or Built Up
usually use for any of these activities: Special or built up Chair
chair.
C132589 HAQ0217 HAQ02-Othr Aid Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Dress/Arising/Eat/Walk) Pain Visual Analog Scale - Aids or devices that you Other Aid (Dress or
usually use for any of these activities: Other. Arising or Eat or Walk)
C132590 HAQ0218 HAQ02-Spec Aid Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Dress/Arising/Eat/Walk) Pain Visual Analog Scale - Aids or devices that you Special Aid (Dress or
usually use for any of these activities: Other (specify). Arising or Eat or Walk)
page 691 of 1925

C132523 HAQ02TC
Code Value
C132591 HAQ0219 HAQ02-Help: Dressing Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
and Grooming Pain Visual Analog Scale - Usually need help from another Help: Dressing and
person: Dressing and grooming. Grooming
C132592 HAQ0220 HAQ02-Help: Arising Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Arising
person: Arising.
C132593 HAQ0221 HAQ02-Help: Eating Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Eating
person: Eating.
C132594 HAQ0222 HAQ02-Help: Walking Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Walking
person: Walking.
C132595 HAQ0223 HAQ02-Wash and Dry Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Your Body Pain Visual Analog Scale - Hygiene: Are you able to wash Wash and Dry Your Body
and dry your body?
C132596 HAQ0224 HAQ02-Take a Tub Bath Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Hygiene: Are you able to take Take a Tub Bath
a tub bath?
C132597 HAQ0225 HAQ02-Get On and Off Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
The Toilet Pain Visual Analog Scale - Hygiene: Are you able to get Get On and Off The Toilet
C132598 HAQ0226 HAQ02-Reach-Get Down Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
5 Lb Obj Above Head Pain Visual Analog Scale - Reach: Are you able to reach Reach-Get Down 5 Lb
and get down a 5-pound object (such as a bag of sugar) Object Above Head
from just above your head?
C132599 HAQ0227 HAQ02-Bend Down Pick Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Up Clothing - Floor Pain Visual Analog Scale - Reach: Are you able to bend Bend Down Pick Up
down to pick up clothing from the floor? Clothing - Floor
C132600 HAQ0228 HAQ02-Open Car Doors Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Grip: Are you able to open car Open Car Doors
doors?
C132601 HAQ0229 HAQ02-Open Jars Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Previously Opened Pain Visual Analog Scale - Grip: Are you able to open jars Open Jars Previously
which have been previously opened? Opened
C132602 HAQ0230 HAQ02-Turn Faucets On Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
And Off Pain Visual Analog Scale - Grip: Are you able to turn Turn Faucets On And Off
faucets on and off?
C132603 HAQ0231 HAQ02-Run Errands and Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Shop Pain Visual Analog Scale - Activities: Are you able to run Run Errands and Shop
errands and shop?
C132604 HAQ0232 HAQ02-Get In and Out of Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
a Car Pain Visual Analog Scale - Activities: Are you able to get Get In and Out of a Car
in and out of a car?
C132605 HAQ0233 HAQ02-Able to Do Chores Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Activities: Are you able to do Able to Do Chores
chores such as vacuuming or yardwork?
C132606 HAQ0234 HAQ02-Aid: Raised Toilet Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Seat Pain Visual Analog Scale - Aids or devices that you Aid: Raised Toilet Seat
usually use for any of these activities: Raised toilet seat.
C132607 HAQ0235 HAQ02-Aid: Bathtub Seat Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Bathtub Seat
C132608 HAQ0236 HAQ02-Aid: Jar Opener Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Previously Open) Pain Visual Analog Scale - Aids or devices that you Aid: Jar Opener
usually use for any of these activities: Jar opener (for jars (Previously Open)
previously opened).
C132609 HAQ0237 HAQ02-Aid: Bathtub Bar Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Bathtub Bar
C132610 HAQ0238 HAQ02-Aid: Long- Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Handled Appl Reach Pain Visual Analog Scale - Aids or devices that you Aid: Long-Handled
usually use for any of these activities: Long-handled Appliances Reach
page 692 of 1925

C132523 HAQ02TC
Code Value
C132611 HAQ0239 HAQ02-Aid: Long- Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Handled Appl Bathroom Pain Visual Analog Scale - Aids or devices that you Aid: Long-Handled
usually use for any of these activities: Long-handled Appliances Bathroom
C132612 HAQ0240 HAQ02-Othr Aid Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Hygiene/Reach/Grip/Act) Pain Visual Analog Scale - Aids or devices that you Other Aid (Hygiene or
usually use for any of these activities: Other. Reach or Grip or Act)
C132613 HAQ0241 HAQ02-Spec Aid Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Hygiene/Reach/Grip/Act) Pain Visual Analog Scale - Aids or devices that you Special Aid (Hygiene or
usually use for any of these activities: Other (specify). Reach or Grip or Act)
C132614 HAQ0242 HAQ02-Help: Hygiene Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Hygiene
person: Hygiene.
C132615 HAQ0243 HAQ02-Help: Reach Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Reach
person: Reach.
C132616 HAQ0244 HAQ02-Help: Gripping Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
and Opening Things Pain Visual Analog Scale - Usually need help from another Help: Gripping and
person: Gripping and opening things. Opening Things
C132617 HAQ0245 HAQ02-Help: Errands and Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Chores Pain Visual Analog Scale - Usually need help from another Help: Errands and Chores
person: Errands and chores.
page 693 of 1925

HAQ02TN (Health Assessment Questionnaire Disability Index Without Pain Visual Analog Scale
C132522 HAQ02TN
Code Value
C132605 HAQ02-Able to Do Chores HAQ02-Able to Do Chores Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Activities: Are you able to do Able to Do Chores
chores such as vacuuming or yardwork?
C132609 HAQ02-Aid: Bathtub Bar HAQ02-Aid: Bathtub Bar Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Bathtub Bar
C132607 HAQ02-Aid: Bathtub Seat HAQ02-Aid: Bathtub Seat Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Bathtub Seat
C132587 HAQ02-Aid: Built Up or HAQ02-Aid: Built Up or Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Special Utensils Special Utensils Pain Visual Analog Scale - Aids or devices that you Aid: Built Up or Special
usually use for any of these activities: Built up or special Utensils
utensils.
C132582 HAQ02-Aid: Cane HAQ02-Aid: Cane Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Cane
C132584 HAQ02-Aid: Crutches HAQ02-Aid: Crutches Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Crutches
C132586 HAQ02-Aid: Devices Used HAQ02-Aid: Devices Used Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
for Dressing for Dressing Pain Visual Analog Scale - Aids or devices that you Aid: Devices Used for
usually use for any of these activities: Devices used for Dressing
Dressing (button hook, zipper pull, long-handled shoe
horn, etc.).
C132608 HAQ02-Aid: Jar Opener HAQ02-Aid: Jar Opener Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Previously Open) (Previously Open) Pain Visual Analog Scale - Aids or devices that you Aid: Jar Opener
usually use for any of these activities: Jar opener (for jars (Previously Open)
previously opened).
C132611 HAQ02-Aid: Long- HAQ02-Aid: Long- Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Handled Appl Bathroom Handled Appl Bathroom Pain Visual Analog Scale - Aids or devices that you Aid: Long-Handled
usually use for any of these activities: Long-handled Appliances Bathroom
C132610 HAQ02-Aid: Long- HAQ02-Aid: Long- Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Handled Appl Reach Handled Appl Reach Pain Visual Analog Scale - Aids or devices that you Aid: Long-Handled
usually use for any of these activities: Long-handled Appliances Reach
C132606 HAQ02-Aid: Raised Toilet HAQ02-Aid: Raised Toilet Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Seat Seat Pain Visual Analog Scale - Aids or devices that you Aid: Raised Toilet Seat
usually use for any of these activities: Raised toilet seat.
C132588 HAQ02-Aid: Special or HAQ02-Aid: Special or Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Built Up Chair Built Up Chair Pain Visual Analog Scale - Aids or devices that you Aid: Special or Built Up
usually use for any of these activities: Special or built up Chair
chair.
C132583 HAQ02-Aid: Walker HAQ02-Aid: Walker Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Walker
C132585 HAQ02-Aid: Wheelchair HAQ02-Aid: Wheelchair Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Aids or devices that you Aid: Wheelchair
C132599 HAQ02-Bend Down Pick HAQ02-Bend Down Pick Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Up Clothing - Floor Up Clothing - Floor Pain Visual Analog Scale - Reach: Are you able to bend Bend Down Pick Up
down to pick up clothing from the floor? Clothing - Floor
C132581 HAQ02-Climb Up Five HAQ02-Climb Up Five Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Steps Steps Pain Visual Analog Scale - Walking: Are you able to climb Climb Up Five Steps
up five steps?
C132577 HAQ02-Cut Your Meat HAQ02-Cut Your Meat Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Eating: Are you able to cut Cut Your Meat
your meat?
page 694 of 1925

C132522 HAQ02TN
Code Value
C132573 HAQ02-Dress Yourself HAQ02-Dress Yourself Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Dressing & Grooming: Are you Dress Yourself
able to dress yourself, including tying shoelaces and
doing buttons?
C132604 HAQ02-Get In and Out of HAQ02-Get In and Out of Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
a Car a Car Pain Visual Analog Scale - Activities: Are you able to get Get In and Out of a Car
in and out of a car?
C132576 HAQ02-Get In and Out of HAQ02-Get In and Out of Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Bed Bed Pain Visual Analog Scale - Arising: Are you able to get in Get In and Out of Bed
and out of bed?
C132597 HAQ02-Get On and Off HAQ02-Get On and Off Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
The Toilet The Toilet Pain Visual Analog Scale - Hygiene: Are you able to get Get On and Off The Toilet
C132592 HAQ02-Help: Arising HAQ02-Help: Arising Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Arising
person: Arising.
C132591 HAQ02-Help: Dressing HAQ02-Help: Dressing Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
and Grooming and Grooming Pain Visual Analog Scale - Usually need help from another Help: Dressing and
person: Dressing and grooming. Grooming
C132593 HAQ02-Help: Eating HAQ02-Help: Eating Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Eating
person: Eating.
C132617 HAQ02-Help: Errands and HAQ02-Help: Errands and Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Chores Chores Pain Visual Analog Scale - Usually need help from another Help: Errands and Chores
person: Errands and chores.
C132616 HAQ02-Help: Gripping HAQ02-Help: Gripping Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
and Opening Things and Opening Things Pain Visual Analog Scale - Usually need help from another Help: Gripping and
person: Gripping and opening things. Opening Things
C132614 HAQ02-Help: Hygiene HAQ02-Help: Hygiene Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Hygiene
person: Hygiene.
C132615 HAQ02-Help: Reach HAQ02-Help: Reach Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Reach
person: Reach.
C132594 HAQ02-Help: Walking HAQ02-Help: Walking Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Usually need help from another Help: Walking
person: Walking.
C132578 HAQ02-Lift a Full Cup or HAQ02-Lift a Full Cup or Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Glass to Mouth Glass to Mouth Pain Visual Analog Scale - Eating: Are you able to lift a Lift a Full Cup or Glass to
full cup or glass to your mouth? Mouth
C132579 HAQ02-Open a New Milk HAQ02-Open a New Milk Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Carton Carton Pain Visual Analog Scale - Eating: Are you able to open a Open a New Milk Carton
new milk carton?
C132600 HAQ02-Open Car Doors HAQ02-Open Car Doors Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Grip: Are you able to open car Open Car Doors
doors?
C132601 HAQ02-Open Jars HAQ02-Open Jars Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Previously Opened Previously Opened Pain Visual Analog Scale - Grip: Are you able to open jars Open Jars Previously
which have been previously opened? Opened
C132589 HAQ02-Othr Aid HAQ02-Othr Aid Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Dress/Arising/Eat/Walk) (Dress/Arising/Eat/Walk) Pain Visual Analog Scale - Aids or devices that you Other Aid (Dress or
usually use for any of these activities: Other. Arising or Eat or Walk)
C132612 HAQ02-Othr Aid HAQ02-Othr Aid Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Hygiene/Reach/Grip/Act) (Hygiene/Reach/Grip/Act) Pain Visual Analog Scale - Aids or devices that you Other Aid (Hygiene or
usually use for any of these activities: Other. Reach or Grip or Act)
C132598 HAQ02-Reach-Get Down HAQ02-Reach-Get Down Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
5 Lb Obj Above Head 5 Lb Obj Above Head Pain Visual Analog Scale - Reach: Are you able to reach Reach-Get Down 5 Lb
and get down a 5-pound object (such as a bag of sugar) Object Above Head
from just above your head?
C132603 HAQ02-Run Errands and HAQ02-Run Errands and Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Shop Shop Pain Visual Analog Scale - Activities: Are you able to run Run Errands and Shop
errands and shop?
page 695 of 1925

C132522 HAQ02TN
Code Value
C132574 HAQ02-Shampoo Your HAQ02-Shampoo Your Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Hair Hair Pain Visual Analog Scale - Dressing & Grooming: Are you Shampoo Your Hair
able to shampoo your hair?
C132590 HAQ02-Spec Aid HAQ02-Spec Aid Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Dress/Arising/Eat/Walk) (Dress/Arising/Eat/Walk) Pain Visual Analog Scale - Aids or devices that you Special Aid (Dress or
usually use for any of these activities: Other (specify). Arising or Eat or Walk)
C132613 HAQ02-Spec Aid HAQ02-Spec Aid Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
(Hygiene/Reach/Grip/Act) (Hygiene/Reach/Grip/Act) Pain Visual Analog Scale - Aids or devices that you Special Aid (Hygiene or
usually use for any of these activities: Other (specify). Reach or Grip or Act)
C132575 HAQ02-Stand Up From a HAQ02-Stand Up From a Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Straight Chair Straight Chair Pain Visual Analog Scale - Arising: Are you able to stand Stand Up From a Straight
up from a straight chair? Chair
C132596 HAQ02-Take a Tub Bath HAQ02-Take a Tub Bath Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Pain Visual Analog Scale - Hygiene: Are you able to take Take a Tub Bath
a tub bath?
C132602 HAQ02-Turn Faucets On HAQ02-Turn Faucets On Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
And Off And Off Pain Visual Analog Scale - Grip: Are you able to turn Turn Faucets On And Off
faucets on and off?
C132580 HAQ02-Walk Outdoors on HAQ02-Walk Outdoors on Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Flat Ground Flat Ground Pain Visual Analog Scale - Walking: Are you able to walk Walk Outdoors on Flat
outdoors on flat ground? Ground
C132595 HAQ02-Wash and Dry HAQ02-Wash and Dry Health Assessment Questionnaire Disability Index Without HAQ-DI Without VAS -
Your Body Your Body Pain Visual Analog Scale - Hygiene: Are you able to wash Wash and Dry Your Body
and dry your body?
page 696 of 1925

HEPENCGR (West Haven Hepatic Encephalopathy Grade)
C117746 HEPENCGR
Code Value
C117824 GRADE 0 Minimal - symptoms or pathological characteristics West Haven Hepatic

include minimal hepatic encephalopathy, lack of Encephalopathy Grade 0
detectable changes in personality or behavior, minimal
changes in memory, concentration and intellectual
function, and absence of coordination asterixis. (Adapted
from: Hepatic Encephalopathy. David C Wolf.
http://emedicine.medscape.com/article/186101-
overview)
C117825 GRADE 1 Mild - symptoms or pathological characteristics include West Haven Hepatic
trivial lack of awareness, shortened attention span, Encephalopathy Grade 1
impaired ability to perform addition or subtraction,
hypersomnia, insomnia, or inversion of sleep pattern,
euphoria, depression or irritability, mild confusion,
slowing of ability to perform mental tasks. (Adapted
from: Hepatic Encephalopathy. David C Wolf.
overview.)
C117826 GRADE 2 Moderate - symptoms or pathological characteristics West Haven Hepatic

include lethargy or apathy, disorientation, inappropriate Encephalopathy Grade 2
behavior, slurred speech, obvious asterixis, drowsiness,
lethargy, gross deficits in ability to perform mental tasks,
obvious personality changes, inappropriate behavior, and
intermittent disorientation, unsurely regarding time.
(Adapted from: Hepatic Encephalopathy. David C Wolf.
overview.)
C117827 GRADE 3 Severe - symptoms or pathological characteristics include West Haven Hepatic
somnolence with some arousability, inability to perform Encephalopathy Grade 3
mental tasks, disorientation about time and place,
marked confusion, amnesia, occasional fits of rage,
present but incomprehensible speech. (Adapted from:
Hepatic Encephalopathy. David C Wolf.
overview.)
C117828 GRADE 4 Coma - symptoms or pathological characteristics include West Haven Hepatic
coma with or without response to painful stimuli. Encephalopathy Grade 4
(Adapted from: Hepatic Encephalopathy. David C Wolf.
overview.)
page 697 of 1925

HESTRESC (Holter ECG Results)
C120522 HESTRESC
Code Value
C111088 1ST DEGREE AV BLOCK 1st degree AV block;PR An electrocardiographic finding of prolonged PR AV Block First Degree by
Prolongation;Prolonged PR interval for a specific population. For adults one ECG Finding
interval common threshold is a PR interval greater than 0.20
seconds. Note that other thresholds may be
applicable.
C71044 2:1 AV BLOCK 2:1 AV block An electrocardiographic finding of a supraventricular 2:1 Atrioventricular Block
rhythm where the ratio of impulses generated above by ECG Finding
the atrioventricular node to the number of impulses
conducted through to the ventricles is 2:1. This is
manifest on the ECG as 2 P waves per QRS
complex.
C62016 2ND DEGREE AV BLOCK Second Degree AV Block An electrocardiographic finding of intermittent AV Block Second Degree
failure of atrial electrical impulse conduction to the by ECG Finding
ventricles. This is manifest on the ECG by regular P
waves which intermittently are not followed by QRS
complexes.
C111091 3RD DEGREE AV BLOCK 3rd Degree Heart Block;AV An electrocardiographic finding of complete failure AV Block Third Degree by
block, complete (third- of atrial electrical impulse conduction to the ECG Finding
degree);Complete Heart Block ventricles. This is manifest on the ECG by
disassociation of atrial and ventricular rhythms. The
atrial rate must be faster than the ventricular rate.
(50 Hz).
(60 Hz).
C116132 ABERRANTLY Aberrantly Conducted Beats An electrocardiographic finding of an abnormally Aberrantly Conducted
CONDUCTED COMPLEXES wide QRS complex(es) of supraventricular origin Complexes by ECG
with prolonged QRS duration due to aberrant AV Finding
conduction.
C114149 AC NOISE AC Noise An electrocardiographic recording showing power Alternating Current Noise
line interference with the electrocardiographic by ECG Finding
(usually 50 Hz or 60 Hz).
C62266 ACCELERATED Accelerated idioventricular An electrocardiographic finding of idioventricular Accelerated

IDIOVENTRICULAR rhythm rhythm with a rate greater than 50 beats per Idioventricular Rhythm by
RHYTHM minute. ECG Finding
C71065 ACUTE ANTERIOR WALL Acute Anterior MI;Acute An electrocardiographic finding of pathologic Q Acute Anterior Myocardial
MYOCARDIAL Anterior Wall Myocardial waves with accompanying ST elevation in leads V3 Infarction by ECG Finding
INFARCTION Infarction and V4, which is suggestive of acute myocardial
infarction of the anterior wall of the left ventricle.
C102591 ACUTE ANTEROLATERAL Acute Anterolateral Wall An electrocardiographic finding of pathologic Q Acute Anterolateral
WALL MYOCARDIAL Myocardial Infarction waves with accompanying ST elevation in leads V3 Myocardial Infarction by
INFARCTION through V6, which is suggestive of acute myocardial ECG Finding
infarction of the anterolateral wall of the left
ventricle.
C102592 ACUTE ANTEROSEPTAL Acute Anteroseptal Wall An electrocardiographic finding of pathologic Q Acute Anteroseptal
WALL MYOCARDIAL Myocardial Infarction;Acute waves with accompanying ST elevation in leads V1 Myocardial Infarction by
INFARCTION anteroseptal MI through V4, which is suggestive of acute myocardial ECG Finding
infarction of the anteroseptal wall of the left
ventricle.
C106496 ACUTE EXTENSIVE An electrocardiographic finding of pathologic Q Acute Extensive Anterior

ANTERIOR WALL waves with accompanying ST elevation in leads V1 Wall Myocardial Infarction
MYOCARDIAL to V6, I and aVL, which is suggestive of acute by ECG Finding
INFARCTION myocardial infarction involving the anterior and
anterolateral walls of the left ventricle.
C102593 ACUTE HIGH LATERAL Acute High Lateral Wall An electrocardiographic finding of pathologic Q Acute High Lateral
WALL MYOCARDIAL Myocardial Infarction waves with accompanying ST elevation in leads I Myocardial Infarction by
INFARCTION and aVL, which is suggestive of acute myocardial ECG Finding
infarction of the high lateral wall of the left ventricle.
page 698 of 1925

C120522 HESTRESC
Code Value
C71066 ACUTE INFERIOR WALL Acute Inferior MI;Acute Inferior An electrocardiographic finding of pathologic Q Acute Inferior Myocardial
MYOCARDIAL Wall Myocardial Infarction waves with accompanying ST elevation in leads III, Infarction by ECG Finding
INFARCTION aVF and often II, which is suggestive of acute
myocardial infarction of the inferior wall of the left
ventricle.
C71067 ACUTE LATERAL WALL Acute Lateral MI;Acute Lateral An electrocardiographic finding of pathologic Q Acute Lateral Myocardial
MYOCARDIAL Wall Myocardial Infarction waves with accompanying ST elevation in leads V5, Infarction by ECG Finding
INFARCTION V6, I and aVL, which is suggestive of acute
myocardial infarction of the lateral wall of the left
ventricle.
C101596 ACUTE MYOCARDIAL Acute Myocardial Infarction An electrocardiographic finding showing a current of Acute Myocardial
INFARCTION injury with ST elevation. No specification is provided Infarction by ECG Finding
for localization.
C71068 ACUTE POSTERIOR WALL Acute Posterior MI;Acute An electrocardiographic finding in leads V1 or V2 of Acute Posterior
MYOCARDIAL Posterior Wall Myocardial an initial R wave duration greater than or equal to Myocardial Infarction by
INFARCTION Infarction 40 ms, R wave greater than S wave, upright T ECG Finding
wave, with accompanying ST elevation, which is
posterior wall of the left ventricle. Evidence of
also present.
C102594 ACUTE RIGHT Acute Right Ventricular Wall An electrocardiographic finding in leads V1 or V2 of Acute Right Ventricular
VENTRICULAR WALL Myocardial Infarction;Acute an initial R wave duration greater than or equal to Myocardial Infarction by
MYOCARDIAL Right ventricular MI 40 ms, R wave greater than S wave, upright T ECG Finding
INFARCTION wave, with accompanying ST elevation, which is
ventricular wall of the left ventricle. Evidence of
also present. Additional criteria include ST elevation
> 100 microvolts in the right precordial leads V4R
through V6R.
C102595 ACUTE SEPTAL WALL Acute Septal Wall Myocardial An electrocardiographic finding of pathologic Q Acute Septal Myocardial
MYOCARDIAL Infarction waves with accompanying ST elevation in leads V1, Infarction by ECG Finding
INFARCTION V2 and often V3, which is suggestive of acute
myocardial infarction of the intraventricular septum.
C102642 ADVANCED/HIGH GRADE Advanced/High Grade AV Block An electrocardiographic finding of intermittent High Grade
AV BLOCK failure of atrial electrical impulse conduction to the Atrioventricular Block by
ventricles, characterized by two or more consecutive ECG Finding
non-conducted P waves.
C114159 ALL PRECORDIAL An electrocardiographic recording in which all All Precordial Electrodes
ELECTRODES precordial electrodes are disconnected resulting in Are Disconnected by ECG
DISCONNECTED missing waveforms (flat line) of all leads V1 - V6. Finding
C71069 ANTERIOR WALL Anterior MI;Anterior Wall An electrocardiographic finding of pathologic Q Anterior Myocardial
MYOCARDIAL Myocardial Infarction waves in leads V3 and V4, which is suggestive of Infarction by ECG Finding
ventricle.
C35303 ANTEROLATERAL WALL Anterolateral Wall Myocardial An electrocardiographic finding of pathologic Q Anterolateral Myocardial
MYOCARDIAL Infarction waves in leads V3 through V6, which is suggestive Infarction by ECG Finding
INFARCTION of myocardial infarction of the anterolateral wall of
the left ventricle.
C35304 ANTEROSEPTAL WALL Anteroseptal MI;Anteroseptal An electrocardiographic finding of pathologic Q Anteroseptal Myocardial
MYOCARDIAL Wall Myocardial Infarction waves in leads V1 through V4, which is suggestive Infarction by ECG Finding
INFARCTION of myocardial infarction of the anteroseptal wall of
the left ventricle.
C114162 ARTIFACT An electrocardiographic recording in which one or Artifact Lead Signal by

more leads display extraneous signals which do not ECG Finding
represent cardiac electrical activity.
C116130 ASYSTOLE An electrocardiographic finding showing no cardiac Asystole by ECG Finding

electrical activity on the ECG for the entire duration
of the recording.
C102596 ATRIAL BIGEMINY An electrocardiographic finding of a sinus beat Atrial Bigeminy by ECG
followed by a premature atrial complex for three or Finding
ratio.
C102597 ATRIAL COUPLETS Atrial Couplets An electrocardiographic finding in which two Atrial Couplet by ECG
premature atrial complexes occur sequentially; Finding
page 699 of 1925

C120522 HESTRESC
Code Value
C71039 ATRIAL ENLARGEMENT Atrial Enlargement An electrocardiographic finding which comprises left, Atrial Enlargement by
right or bilateral atrial enlargement. This is may be ECG Finding
characterized by prolonged P wave duration,
increased P wave amplitude, or multi-component P
waves.
C111092 ATRIAL FIBRILLATION Atrial fibrillation An electrocardiographic finding of a supraventricular Atrial Fibrillation by ECG
arrhythmia characterized by the replacement of Finding
consistent P waves by rapid oscillations or
fibrillatory waves that vary in size, shape and timing
and are accompanied by an irregularly irregular
ventricular response.
C111094 ATRIAL FLUTTER Atrial flutter An electrocardiographic finding of an organized, Atrial Flutter by ECG
regular atrial rhythm with atrial rate of 240-340 Finding
beats per minute. Multiple P waves typically appear
in the inferior leads in a saw tooth like pattern
between the QRS complexes.
C111105 ATRIAL TACHYCARDIA Atrial tachycardia An electrocardiographic finding of an organized, Atrial Tachycardia by ECG
regular atrial rhythm with atrial rate between 101 Finding
and 240 beats per minute. The P wave morphology
must be distinct from the sinus P wave morphology.
C119249 ATRIAL TACHYCARDIA An electrocardiographic finding of an atrial Atrial Tachycardia With

WITH AV BLOCK tachycardia which does not display 1:1 AV AV Block by ECG Finding
conduction.
C102598 ATRIAL TRIGEMINY Atrial Trigeminy An electrocardiographic finding of two sinus beats Atrial Trigeminy by ECG
followed by a premature atrial complex for 3 or Finding
ratio.
C71045 ATRIOVENTRICULAR AV Dissociation;Atrioventricular An electrocardiographic finding in which the Atrioventricular

DISSOCIATION dissociation electrical activity of the atria and ventricles are Dissociation by ECG
independent of one another. Finding
C111089 AV MOBITZ I AV Mobitz I;Mobitz I Second An electrocardiographic finding of intermittent AV Block Second Degree
Degree AV Block;Second failure of atrial electrical impulse conduction to the Mobitz Type I by ECG
degree AV block- Mobitz type ventricles, characterized by a progressively Finding
I;Second-degree AV block, lengthening PR interval prior to the block of an atrial
Mobitz type I impulse.
(Wenckebach);Type 1 2nd
degree AV Block;Wenckebach
C111090 AV MOBITZ II Mobitz II AV Block;Mobitz II An electrocardiographic finding of intermittent AV Block Second Degree
Second Degree AV Block;Type failure of atrial electrical impulse conduction to the Mobitz Type II by ECG
2 2nd degree AV Block ventricles, characterized by a relatively constant PR Finding
interval prior to the block of an atrial impulse.
C35058 AV NODE RE-ENTRY AV Node Reentrant An electrocardiographic finding of a regular Atrioventricular Nodal
Supraventricular Tachycardia supraventricular tachycardia due to reentry within Reentry Tachycardia by
the AV node. It is characterized by P waves which ECG Finding
typically occurs nearly simultaneously with the QRS
complex, resulting in a P wave which is obscured by
the QRS, merged with the QRS or which may follow
the QRS.
C62261 AV RE-ENTRANT AV Reentrant Supraventricular An electrocardiographic finding of a regular Atrioventricular Reentrant

TACHYCARDIA Tachycardia supraventricular tachycardia which utilizes an Tachycardia by ECG
atrioventricular bypass tract as its retrograde limb Finding
(orthodromic tachycardia) or as its antegrade limb
(antidromic tachycardia). QRS complexes during
sinus rhythm may show preexcitation. During
orthodromic tachycardia the preexcitation is not
present and a retrograde P wave may appear after
the QRS complex. During antidromic tachycardia the
QRS complex is preexcited.
C114147 BASELINE WANDER An electrocardiographic recording in which the Baseline Wander by ECG
isoelectric line in one or more leads is vertically Finding
displaced resulting in low frequency upward and
downward movements of the signal with varying
amplitudes.
C71046 BIFASCICULAR BLOCK Bifascicular block An electrocardiographic finding comprising right Bifascicular Block by ECG
bundle branch block and left anterior fascicular Finding
block, or right bundle branch block and left posterior
fascicular block. Defects occurring in two of the
three divisions of the conduction system of the heart
are considered bifascicular blocks. Technically left
bundle branch block may be considered a
bifascicular block. (NCI)
page 700 of 1925

C120522 HESTRESC
Code Value
C106502 BIVENTRICULAR An electrocardiographic finding suggestive of Biventricular Hypertrophy

HYPERTROPHY enlargement or thickening of both ventricles, with a by ECG Finding
combination of findings which are related to LVH
and RVH, such as voltage criteria for LVH in the
presence of marked right axis deviation.
C92228 BORDERLINE QTCB Borderline QTcB An electrocardiographic finding in which the QT Borderline QTcB
C92229 BORDERLINE QTCF Borderline QTcF An electrocardiographic finding in which the QT Borderline QTcF
C111120 BRADYCARDIA Bradycardia An electrocardiographic finding of abnormally slow Bradycardia by ECG

C106503 BRUGADA SYNDROME An electrocardiographic finding of complete or Brugada Syndrome

PATTERN incomplete right bundle branch block accompanied Pattern by ECG Finding
by ST elevation in leads V1-V3. This may be noted
at rest or can be provoked by medication challenge.
C120609 DEFIBRILLATOR An electrocardiographic finding of an artifact Defibrillator Discharge by

DISCHARGE generated by an external or internal cardioversion ECG Finding
or defibrillation shock.
C62258 DELTA WAVE Delta wave An electrocardiographic finding of initial slurring Delta Wave by ECG
(delta wave) of the QRS complex due to the Finding
presence of an accessory pathway. This
characteristic ECG pattern is typically seen in Wolff-
Parkinson-White syndrome.
C102623 DEXTROCARDIA Dextrocardia An electrocardiographic finding suggestive of Dextrocardia by ECG

dextrocardia with situs inversus, characterized by Finding
reversal of normal anterior R wave progression and
the appearance of reversal of the right and left arm
electrodes.
C102628 EARLY R WAVE Early R Wave Progression;Early An electrocardiographic finding where the amplitude Early R Wave Transition
TRANSITION R Wave Transition of the R wave becomes greater than the amplitude by ECG Finding
of the S wave in the QRS complex at an unusually
early point in the precordial leads, usually in leads
V1 or V2.
C102629 EARLY REPOLARIZATION Early Repolarization An electrocardiographic finding of J point and ST Early Repolarization
segment elevation in the absence of other signs of
acute ischemia or pericarditis.
C114175 ECG ACQUIRED WITH An electrocardiographic recording in which the ECG Acquired with
PRECORDIAL precordial electrodes have been placed over the Precordial Electrodes
ELECTRODES PLACED ON right chest and record a right sided ECG. Placed on the Right Chest
RIGHT CHEST
C114181 ECG EVALUATION NOT A digital electrocardiographic recording which is ECG Evaluation Not
PERFORMED DUE TO corrupted (i.e. ECG signal cannot be restored) such Performed Due to
CORRUPTED DIGITAL that measurements and/or interpretation cannot be Corrupted Digital ECG File
ECG FILE performed.
C62245 ECTOPIC ATRIAL RHYTHM Ectopic atrial rhythm An electrocardiographic finding of a regular atrial Ectopic Atrial Rhythm by
rhythm with atrial rate of less than 101 beats per ECG Finding
minute which does not originate in the sinus node,
and which is characterized by P waves whose
morphology differs from the P wave morphology
during sinus rhythm.
C71042 ECTOPIC VENTRICULAR Ectopic ventricular rhythm An electrocardiographic finding of three or more Ectopic Ventricular
RHYTHM consecutive complexes of ventricular origin. The Rhythm by ECG Finding
QRS complexes are wide and have an abnormal
morphology.
C71035 ELECTRICAL ALTERNANS Electrical alternans An electrocardiographic finding in which there is an Electrical Alternans by
alternating pattern of any of the waveform ECG Finding
components. (NCI)
C106520 EXTENSIVE ANTERIOR An electrocardiographic finding of pathologic Q Extensive Anterior Wall

WALL MYOCARDIAL waves in leads V1 to V6, I and aVL, which is Myocardial Infarction by
INFARCTION suggestive of myocardial infarction involving the ECG Finding
anterior and anterolateral walls of the left ventricle.
page 701 of 1925

C120522 HESTRESC
Code Value
C120610 FREQUENT PREMATURE An electrocardiographic finding during a continuous Frequent Premature Atrial
ATRIAL COMPLEXES recording in which the frequency of atrial premature Complexes by ECG
complexes exceeds the normal threshold. Note that Finding
different thresholds may apply to different patient
populations.
C120611 FREQUENT PREMATURE An electrocardiographic finding during a continuous Frequent Premature

VENTRICULAR recording in which the frequency of ventricular Ventricular Complexes by
COMPLEXES premature complexes exceeds the normal threshold. ECG Finding
Note that different thresholds may apply to different
patient populations.
C102639 FUSION COMPLEX Fusion Beat;Fusion Complexes An electrocardiographic finding that occurs when Fusion Complex
electrical activation of the atria or ventricles occurs
from two separate sites. This results in a P wave or
QRS complex that displays merged characteristics of
beats originating from the two different sites; there
C102643 HIGH LATERAL WALL High Lateral Wall Myocardial An electrocardiographic finding of pathologic Q High Lateral Myocardial
MYOCARDIAL Infarction waves in leads I and aVL, which is suggestive of Infarction by ECG Finding
INFARCTION myocardial infarction of the high lateral wall of the
left ventricle.
C120612 HOLTER LEAD FAIL A continuous, ambulatory electrocardiographic Holter Lead Fail by ECG
recording during which one or more electrodes are Finding
disconnected, at least temporarily, resulting in one
or more invalid ECG waveforms.
C50599 IDIOVENTRICULAR Idioventricular Rhythm An electrocardiographic finding of three or more Idioventricular Rhythm
RHYTHM consecutive complexes of ventricular origin with a
rate less than a certain threshold (100 or 120 beats
per minute are commonly used). The QRS
morphology.
C71047 INCOMPLETE LEFT Incomplete left bundle branch An electrocardiographic finding of a wide QRS Incomplete Left Bundle
BUNDLE BRANCH BLOCK block complex with evidence of delayed conduction to the Branch Block by ECG
left ventricle, manifest as a widened initial portion of Finding
with QRS duration less than 120 ms.
C71048 INCOMPLETE RIGHT Incomplete right bundle branch An electrocardiographic finding of a wide QRS Incomplete Right Bundle
BUNDLE BRANCH BLOCK block;Incomplete right bundle- complex with evidence of delayed conduction to the Branch Block by ECG
branch block right ventricle, manifest by a widened initial portion Finding
V6, I and aVL, and with QRS duration less than 120
ms.
C102701 INDETERMINATE QRS Indeterminate An electrocardiographic finding in which the frontal QRS Axis Indeterminate
AXIS Axis;Indeterminate QRS plane QRS axis cannot be calculated.
Axis;QRS Axis Indeterminate
C35398 INFERIOR WALL Inferior MI;Inferior Wall An electrocardiographic finding of pathologic Q Inferior Myocardial
MYOCARDIAL Myocardial Infarction waves in leads III, aVF and often II, which is Infarction by ECG Finding
C71073 INTRAATRIAL Intraatrial Conduction Delay An electrocardiographic finding of a delay in impulse Intra-Atrial Conduction
CONDUCTION DELAY propagation through the atria. This is characterized Delay by ECG Finding
by broad P waves which are often biphasic in V1.
C62271 INTRAVENTRICULAR Intraventricular Conduction An electrocardiographic finding of a widened QRS Nonspecific

CONDUCTION DELAY, Defect;Intraventricular duration typically greater than 110 ms which does Intraventricular
NONSPECIFIC conduction delay not meet the morphologic criteria for any of the Conduction Delay by ECG
standard bundle branch or fascicular block patterns. Finding
C62248 ISORHYTHMIC Isorhythmic dissociation An electrocardiographic finding of a type of Isorhythmic

DISSOCIATION atrioventricular dissociation characterized by the Atrioventricular
atria (P waves) and ventricles (QRS complexes) Dissociation
beating at similar rates, although independently.
C71030 J POINT ELEVATION J point elevation An electrocardiographic finding of a significant J Point Elevation
elevation above the baseline of the J point.
C71074 JUNCTIONAL Junctional bradycardia An electrocardiographic finding of a junctional Junctional Bradycardia by

BRADYCARDIA rhythm with a heart rate which is abnormally low. ECG Finding
C116129 JUNCTIONAL ESCAPE Junctional Escape An electrocardiographic finding of an escape beat Junctional Escape
COMPLEXES Beat;Junctional Escape following a pause which originates in the AV Complexes by ECG
Complex junction. This is manifest as a QRS complex of Finding
supraventricular origin not preceded by a P wave;
page 702 of 1925

C120522 HESTRESC
Code Value
C135393 JUNCTIONAL ESCAPE An electrocardiographic finding of a junctional Junctional Escape Rhythm

RHYTHM rhythm that arises as a physiologic response to by ECG Finding
extreme slowing or arrest of sinus node activity. In
this setting, a faster junctional rhythm may be a
normal response to a very slow or absent sinus rate.
C102652 JUNCTIONAL PREMATURE Junctional Extra An electrocardiographic finding of an ectopic impulse Junctional Premature
COMPLEX Beat;Junctional Premature originating in the AV junction presenting as a QRS Complex by ECG Finding
Complexes complex of supraventricular origin which is not
preceded by a P wave; there may be one or more
occurrences during an electrocardiographic
recording.
C71051 JUNCTIONAL RHYTHM Junctional rhythm An electrocardiographic finding of a rhythm which Junctional Rhythm by
originates in the AV junction and results in a normal ECG Finding
heart rate. It is characterized by retrograde P waves
which may be obscured by or may follow the QRS
complexes. The QRS complexes may be narrow or
may demonstrate aberration.
C35059 JUNCTIONAL Junctional tachycardia An electrocardiographic finding of a junctional Junctional Tachycardia by

TACHYCARDIA rhythm with a heart rate which is abnormally ECG Finding
elevated.
C102653 LATE R WAVE Late R Wave Transition An electrocardiographic finding where the amplitude Late R Wave Transition
TRANSITION of the R wave does not become greater than the by ECG Finding
amplitude of the S wave until an unusually late
point in the precordial leads, usually in leads V4 to
V6.
C35586 LATERAL WALL Lateral MI;Lateral Wall An electrocardiographic finding of pathologic Q Lateral Myocardial
MYOCARDIAL Myocardial Infarction waves in leads V5, V6, I and aVL, which is Infarction by ECG Finding
C62267 LEFT ANTERIOR Left Anterior Hemiblock;Left An electrocardiographic finding of a slightly widened Left Anterior Fascicular
FASCICULAR BLOCK anterior fascicular block QRS duration (typically less than 120 ms) with Block by ECG Finding
leftward frontal plane QRS axis and typically small Q
waves in leads I and aVL.
C71040 LEFT ATRIAL Left Atrial Enlargement;P- An electrocardiographic finding suggesting P-mitrale by ECG Finding
ABNORMALITY mitrale underlying hypertrophy or dilatation of the left
diagnosis of left atrial abnormality may include a
bifid p wave, a biphasic p wave and/or a p wave
duration of greater than 0.12 seconds. (NCI)
C62269 LEFT BUNDLE BRANCH Complete LBBB;Left bundle An electrocardiographic finding of a wide QRS Left Bundle Branch Block
BLOCK branch block;Left bundle- complex with evidence of delayed conduction to the by ECG Finding
branch block left ventricle, manifest as a widened initial portion of
with QRS duration greater than or equal to 120 ms.
C62268 LEFT POSTERIOR Left Posterior Hemiblock;Left An electrocardiographic finding of an S1Q3 pattern Left Posterior Fascicular
FASCICULAR BLOCK posterior fascicular block and QRS axis greater than or equal to 120 degrees. Block by ECG Finding
It is usually seen in association with other
abnormalities (e.g. RBBB or RVH).
C92231 LEFT VENTRICULAR Left Ventricular Conduction An electrocardiographic finding in which there is Left Ventricular
CONDUCTION DELAY Delay evidence that electrical transmission through the left Conduction Delay by ECG
ventricle is impaired. Finding
HYPERTROPHY hypertrophied left ventricle, characterized by large Hypertrophy by ECG
QRS amplitudes and secondary findings of left atrial Finding
enlargement, left axis deviation, or typical pattern
of ST depression and T wave inversion.
HYPERTROPHY WITH With Strain hypertrophied left ventricle, characterized by large Hypertrophy with Strain
STRAIN QRS amplitudes, ST depression and T wave by ECG Finding
inversion.
C114151 LIMB ELECTRODE(S) An electrocardiographic recording in which one or Disconnected Limb

DISCONNECTED more of the limb electrodes are disconnected Electrodes by ECG Finding
resulting in missing waveforms (often flat lines) of
the respective leads.
C114150 LIMB ELECTRODES Limb Lead Reversal An electrocardiographic recording in which two or Interchanged Limb
INTERCHANGED more of the limb electrodes are switched resulting in Electrodes by ECG Finding
improper representation of the affected leads.
page 703 of 1925

C120522 HESTRESC
Code Value
C114166 LOW AMPLITUDE SIGNAL Low Amplitude QRS Complex An electrocardiographic recording showing smaller Low Amplitude QRS
than usual QRS complexes in one or more leads. Complex by ECG Finding
This may represent a technical issue with the ECG
acquisition or characteristics of the individual.
C71078 LOW QRS VOLTAGE Low QRS voltage An electrocardiographic finding of a QRS amplitude Low QRS Voltage by ECG
less than or equal to 0.5 mV in the limb leads or Finding
QRS amplitude less than or equal to 1 mV in the
precordial leads.
C116133 LOW VOLTAGE - LIMB An electrocardiographic finding of small QRS Low Voltage in Limb
LEADS ONLY amplitudes (less than 500 microvolts) in all limb Leads Only by ECG
leads. Finding
C120613 MARKED SINUS An electrocardiographic finding of sinus bradycardia Marked Sinus Bradycardia
BRADYCARDIA with a heart rate below a threshold of clinical by ECG Finding
concern. Note that different thresholds (for rate
and/or duration) may apply to different patient
populations.
C71050 MULTIFOCAL ATRIAL Multifocal atrial tachycardia An electrocardiographic finding of a supraventricular Multifocal Atrial
TACHYCARDIA arrhythmia characterized by 3 or more distinct P Tachycardia by ECG
rhythm. The ventricular rate is typically 100-150
beats per minute.
C114148 MUSCLE TREMOR An electrocardiographic recording with intermittent Muscle Tremor Artifact
mid to high frequency artifact in one or more leads
due to muscular tremor or movement rather than
cardiac activity.
C101589 MYOCARDIAL Myocardial Infarction An electrocardiographic finding of pathologic Q Myocardial Infarction by

INFARCTION waves, which is suggestive of myocardial infarction ECG Finding
of one or more regions of the heart. No specification
is provided for localization.
C102732 NEW ANTERIOR WALL New Anterior MI;New Anterior An electrocardiographic finding of pathologic Q New Anterior Myocardial
MYOCARDIAL Wall Myocardial Infarction waves in leads V3 and V4, which is suggestive of Infarction by ECG Finding
ventricle and which is new compared to prior ECGs.
C102733 NEW ANTEROLATERAL New Anterolateral Wall An electrocardiographic finding of pathologic Q New Anterolateral
INFARCTION of myocardial infarction of the anterolateral wall of ECG Finding
ECGs.
C102734 NEW ANTEROSEPTAL New Anteroseptal Wall An electrocardiographic finding of pathologic Q New Anteroseptal
INFARCTION of myocardial infarction of the anteroseptal wall of ECG Finding
ECGs.
C102735 NEW EXTENSIVE New Extensive Anterior Wall An electrocardiographic finding of pathologic Q New Extensive Anterior
ANTERIOR WALL Myocardial Infarction waves in leads V1 to V6, I and aVL, which is Myocardial Infarction by
MYOCARDIAL suggestive of myocardial infarction involving the ECG Finding
INFARCTION anterior and anterolateral walls of the left ventricle
and which is new compared to prior ECGs.
C102736 NEW HIGH LATERAL New High Lateral Wall An electrocardiographic finding of pathologic Q New High Lateral
WALL MYOCARDIAL Myocardial Infarction waves in leads I and aVL, which is suggestive of Myocardial Infarction by
INFARCTION myocardial infarction of the high lateral wall of the ECG Finding
left ventricle and which is new compared to prior
ECGs.
C102737 NEW INFERIOR WALL New Inferior Wall Myocardial An electrocardiographic finding of pathologic Q New Inferior Myocardial
MYOCARDIAL Infarction waves in leads III, aVF and often II, which is Infarction by ECG Finding
to prior ECGs.
C102738 NEW LATERAL WALL New Lateral Wall Myocardial An electrocardiographic finding of pathologic Q New Lateral Myocardial
MYOCARDIAL Infarction waves in leads V5, V6, I and aVL, which is Infarction by ECG Finding
to prior ECGs.
C102731 NEW MYOCARDIAL New Myocardial Infarction An electrocardiographic finding of pathologic Q New Myocardial Infarction
INFARCTION waves, which is suggestive of myocardial infarction by ECG Finding
of one or more regions of the heart and which is
new compared to prior ECGs. No specification is
provided for localization.
page 704 of 1925

C120522 HESTRESC
Code Value
C106548 NEW POSTERIOR WALL An electrocardiographic finding in leads V1 or V2 of New Posterior Wall
MYOCARDIAL an initial R wave duration greater than or equal to Myocardial Infarction by
INFARCTION 40 ms, R wave greater than S wave, and upright T ECG Finding
the posterior wall of the left ventricle, and which is
new compared to prior ECGs. Evidence of inferior or
lateral myocardial infarction is usually also present.
C102739 NEW SEPTAL WALL New Septal Wall Myocardial An electrocardiographic finding of pathologic Q New Septal Myocardial
MYOCARDIAL Infarction waves in leads V1, V2 and often V3, which is Infarction by ECG Finding
INFARCTION suggestive of myocardial infarction of the
intraventricular septum and which is new compared
to prior ECGs.
C114163 NO ECG WAVEFORMS An electrocardiographic recording that displays flat ECG Waveforms Not
PRESENT lines (no waveforms are visible) in all leads present. Present
C71080 NON Q WAVE Non Q Wave Myocardial An electrocardiographic finding of ST and T wave Non Q Wave Myocardial
MYOCARDIAL Infarction abnormalities in the absence of pathologic Q waves, Infarction by ECG Finding
INFARCTION which is suggestive of myocardial infarction in one
or more regions of the heart.
C116134 NON-DIAGNOSTIC Q An electrocardiographic finding of Q waves which Non-Diagnostic Q Waves

WAVES are insufficient for the diagnosis of myocardial by ECG Finding
infarction. In such cases a myocardial infarction may
be suspected, even though ECG criteria are not met.
C71031 NON-SPECIFIC ST-T Non-specific ST-T changes An electrocardiographic finding of changes in the ST Non-Specific ST-T
CHANGES segment and T wave that do not meet criteria for Changes by ECG Finding
ischemia or infarction. (NCI)
C102680 NON-SUSTAINED ATRIAL Non-Sustained Atrial An electrocardiographic finding of an atrial Non-Sustained Atrial
TACHYCARDIA Tachycardia tachycardia which terminates in less than 30 Tachycardia by ECG
seconds. Finding
C71053 NON-SUSTAINED Non-sustained ventricular An electrocardiographic finding of ventricular Non-Sustained

VENTRICULAR tachycardia;Ventricular tachycardia less than 30 seconds in duration. (NCI) Ventricular Tachycardia
TACHYCARDIA tachycardia, unsustained by ECG Finding
C135394 NONCONDUCTED P WAVE An electrocardiographic finding of a P wave that Nonconducted P Wave

PHYSIOLOGY NOT does not conduct to the ventricle or result in Physiology Not Defined by
DEFINED ventricular activation. ECG Finding
C120614 NONSUSTAINED An electrocardiographic finding of a supraventricular Nonsustained

SUPRAVENTRICULAR tachycardia with duration shorter than 30 seconds Supraventricular
TACHYCARDIA (though other duration thresholds may be applied). Tachycardia by ECG
Finding
C102681 NORMAL SINUS RHYTHM Normal Sinus Rhythm An electrocardiographic finding of an atrial rhythm Normal Sinus Rhythm
considered normal for the population. There are no
extra beats or conduction abnormalities.
C102634 NORTHWEST AXIS Northwest Axis;Right superior An electrocardiographic finding of a frontal plane Extreme Right Axis
axis QRS axis from -90 to +180 degrees. Deviation
C71032 NOTCHED T WAVES Notched T Waves An electrocardiographic finding of an irregular, u or T Wave Notched by ECG
v shaped deflection within the contour of the T Finding
wave.
INDETERMINATE Anterior Wall Myocardial waves in leads V3 and V4, which is suggestive of Anterior Myocardial
ANTERIOR WALL Infarction myocardial infarction of the anterior wall of the left Infarction by ECG Finding
MYOCARDIAL ventricle, without evidence of current or ongoing
INDETERMINATE Anterolateral Wall Myocardial waves in leads V3 through V6, which is suggestive Anterolateral Myocardial
ANTEROLATERAL WALL Infarction of myocardial infarction of the anterolateral wall of Infarction by ECG Finding
INDETERMINATE Anteroseptal Wall Myocardial waves in leads V1 through V4, which is suggestive Anteroseptal Myocardial
ANTEROSEPTAL WALL Infarction of myocardial infarction of the anteroseptal wall of Infarction by ECG Finding
INDETERMINATE Extensive Anterior Wall waves in leads V1 to V6, I and aVL, which is Extensive Anterior
EXTENSIVE ANTERIOR Myocardial Infarction suggestive of myocardial infarction involving the Myocardial Infarction by
WALL MYOCARDIAL anterior and anterolateral walls of the left ventricle, ECG Finding
INFARCTION without evidence of current or ongoing acute
infarction.
page 705 of 1925

C120522 HESTRESC
Code Value
C102688 OLD OR AGE Old Or Age Indeterminate High An electrocardiographic finding of pathologic Q Old or Age Indeterminate
INDETERMINATE HIGH Lateral Wall Myocardial waves in leads I and aVL, which is suggestive of High Lateral Myocardial
LATERAL WALL Infarction myocardial infarction of the high lateral wall of the Infarction by ECG Finding
MYOCARDIAL left ventricle, without evidence of current or ongoing
INDETERMINATE Inferior Wall Myocardial waves in leads III, aVF and often II, which is Inferior Myocardial
INFERIOR WALL Infarction suggestive of myocardial infarction of the inferior Infarction by ECG Finding
INDETERMINATE Lateral Wall Myocardial waves in leads V5, V6, I and aVL, which is Lateral Myocardial
LATERAL WALL Infarction suggestive of myocardial infarction of the lateral Infarction by ECG Finding
C102691 OLD OR AGE Old Or Age Indeterminate An electrocardiographic finding in leads V1 or V2 of Old or Age Indeterminate
INDETERMINATE Posterior Wall Myocardial an initial R wave duration greater than or equal to Posterior Myocardial
POSTERIOR WALL Infarction 40 ms, R wave greater than S wave, and upright T Infarction by ECG Finding
MYOCARDIAL wave, which is suggestive of myocardial infarction of
INFARCTION the posterior wall of the left ventricle, without
evidence of current or ongoing acute infarction.
Evidence of inferior or lateral myocardial infarction
is usually also present.
INDETERMINATE SEPTAL Septal Wall Myocardial waves in leads V1, V2 and often V3, which is Septal Myocardial
WALL MYOCARDIAL Infarction suggestive of myocardial infarction of the Infarction by ECG Finding
INFARCTION intraventricular septum, without evidence of current
or ongoing acute infarction.
C101597 OLD OR AGE Old Or Age Indeterminate Wall An electrocardiographic finding of pathologic Q Old Myocardial Infarction
INDETERMINATE WALL Myocardial Infarction waves, which is suggestive of myocardial infarction by ECG Finding
MYOCARDIAL of one or more regions of the heart, without
INFARCTION evidence of current or ongoing acute infarction. No
specification is provided for localization.
C102692 OLD OR AGE An electrocardiographic finding, in the presence of Old or Age Indeterminate
UNDETERMINED RIGHT an old or age indeterminate inferior wall myocardial Right Ventricular
VENTRICULAR infarction, of Q waves greater than or equal to 40 Myocardial Infarction by
MYOCARDIAL ms in duration in the right ventricular leads V4R ECG Finding
INFARCTION through V6R.
C114176 OTHER INCORRECT An electrocardiographic recording in which one or Other Incorrect Electrode
ELECTRODE PLACEMENT more electrodes are incorrectly placed but further Placement
details are not provided.
C90430 P WAVE ABNORMALITY P Wave Abnormality An electrocardiographic finding for the P wave that P Wave Abnormality by
is atypical either for the shape, duration, amplitude, ECG Finding
axis or polarity. Abnormality of the P wave signifies
aberrant propagation of the electrical impulse
through the atria. (NCI)
C90431 P WAVE NOTCHED P Wave Notched An electrocardiographic finding of P waves with two P Wave Notched by ECG
peaks longer in duration than normal and amplitude Finding
greater than normal.
C92232 PACED ATRIAL AND AV dual-paced complex(es) or An electrocardiographic finding in which both the Paced Atrial And
VENTRICULAR RHYTHM rhythm;Paced Atrial And atrial and ventricular rhythm are controlled by an Ventricular Rhythm
Ventricular Rhythm electrical impulse from an artificial cardiac
pacemaker.
C92233 PACED ATRIAL RHYTHM Atrial-paced complex(es) or An electrocardiographic finding in which the atrial Paced Atrial Rhythm
rhythm;Paced Atrial Rhythm rhythm is controlled by an electrical impulse from an
C88140 PACED RHYTHM Atrial and/or Ventricular Paced An electrocardiographic finding in which the cardiac Paced Rhythm
Rhythm;Paced Rhythm rhythm is controlled by an electrical impulse from an
C92234 PACED VENTRICULAR Paced Ventricular An electrocardiographic finding in which the Paced Ventricular Rhythm
RHYTHM Rhythm;Ventricular-paced ventricular rhythm is controlled by an electrical
complex(es) or rhythm impulse from an artificial cardiac pacemaker.
C120615 PAROXYSMAL ATRIAL An electrocardiographic finding of atrial fibrillation Paroxysmal Atrial

FIBRILLATION which occurs intermittently during the recording. Fibrillation by ECG
Other rhythms which may be present are sinus Finding
rhythm, junctional rhythm, or an atrial paced
rhythm.
C62250 PAROXYSMAL AV BLOCK Paroxysmal AV block An electrocardiographic finding of the sudden onset Paroxysmal
of transient AV block, which is often associated with Atrioventricular Block by
preexisting conduction disorders. ECG Finding
page 706 of 1925

C120522 HESTRESC
Code Value
C34902 PAROXYSMAL Paroxysmal Ventricular An episodic form of ventricular tachycardia, with Paroxysmal Ventricular
VENTRICULAR Tachycardia abrupt onset and termination. (NCI) Tachycardia by ECG
TACHYCARDIA Finding
C119250 PAUSE An electrocardiographic finding of an RR interval Pause by ECG Finding

which exceeds a predefined duration threshold,
regardless of the underlying rhythm.
C119251 PAUSE GREATER THAN An electrocardiographic finding of an RR interval Pause Greater Than Three
3.0 SECONDS with duration greater than 3.0 seconds, regardless Seconds by ECG Finding
of the underlying rhythm.
C120616 PERSISTENT ATRIAL An electrocardiographic finding of atrial fibrillation Persistent Atrial

FIBRILLATION which is present during the entire recording. Fibrillation by ECG
Finding
C114172 POOR QUALITY ECG An electrocardiographic recording that does not Poor Quality ECG
show proper quality for reasons that are not
otherwise described.
C71033 POOR R WAVE Poor R Wave Progression An electrocardiographic finding of a lack of Poor R Wave Progression
PROGRESSION progression of R wave height across precordial by ECG Finding
leads.
C35399 POSTERIOR WALL Posterior MI;Posterior Wall An electrocardiographic finding in leads V1 or V2 of Posterior Myocardial
MYOCARDIAL Myocardial Infarction an initial R wave duration greater than or equal to Infarction by ECG Finding
INFARCTION 40 ms, R wave greater than S wave, and upright T
the posterior wall of the left ventricle. Evidence of
also present.
C116135 PR SEGMENT PR Depression An electrocardiographic finding of PR segment PR Segment Depression

DEPRESSION depression below the iso-electric line in multiple by ECG Finding
precordial and/or limb leads.
C34940 PRE-EXCITATION Pre-excitation;Ventricular An electrocardiographic finding characterized by a Pre-Excitation Syndrome

preexcitation premature activation of the whole or some part of
the ventricle. The PR interval is usually shortened
and delta waves are frequently present.






C114160 PRECORDIAL An electrocardiographic recording in which one or Incorrectly Positioned

ELECTRODE(S) more precordial electrodes are placed incorrectly Precordial Electrodes by
POSITIONED with respect to the standard chest electrode ECG Finding
INCORRECTLY positions resulting in improper representation of the
affected leads.
C114152 PRECORDIAL Precordial Lead Reversal An electrocardiographic recording in which two or Interchanged Precordial
ELECTRODES more of the precordial electrodes are switched Electrodes by ECG Finding
INTERCHANGED resulting in improper representation of the affected
leads.
C62257 PREMATURE ATRIAL APC;Atrial premature An electrocardiographic finding of an ectopic impulse Atrial Premature Complex
COMPLEXES complex(es);PAC;Premature originating in the atria and not specifically in the by ECG Finding
atrial sinus node. The P wave morphology of these
complex;SVE;Supraventricular complexes is often different from a sinus P wave
Extra Beat;Supraventricular and the RR intervals preceding these complexes is
Premature Beat also shorter than those of the regular beats; there
page 707 of 1925

C120522 HESTRESC
Code Value
C102603 PREMATURE ATRIAL Atrial premature complexes, An electrocardiographic finding of a premature atrial Blocked Atrial Premature
COMPLEXES BLOCKED nonconducted;Non-conducted complexes that are is not conducted to the Complex by ECG Finding
SVE;Premature Atrial Complex ventricles, and that are is not followed by a QRS
Blocked;Premature Atrial complex; there may be one or more occurrences
Complexes Non-conducted during an electrocardiographic recording.
C102672 PREMATURE ATRIAL Multifocal SVE;Multifocal An electrocardiographic finding of premature atrial Multifocal Atrial
COMPLEXES MULTIFOCAL Supraventricular Extra complexes which have 2 or more distinct Premature Complex by
Beats;Premature Atrial morphologies, suggesting origin at more than one ECG Finding
Complexes Multiform atrial site.
C102724 PREMATURE ATRIAL Premature Atrial Complexes An electrocardiographic finding of premature atrial Unifocal Atrial Premature
COMPLEXES UNIFOCAL Unifocal complexes which have a single distinct morphology, Complex by ECG Finding
suggesting origin at one atrial site.
C62256 PREMATURE PVC;Premature Ventricular An electrocardiographic finding of an ectopic impulse Ventricular Premature
VENTRICULAR COMPLEX Complexes;VE;VES;VPC;Ventri originating in the ventricles. The QRS morphology of Complex by ECG Finding
cular Extra Beat;Ventricular these complexes is different from those of
Premature Complexes supraventricular origin. The QRS duration is often
longer and the RR interval preceding the complexes
is usually shorter than that of supraventricular
beats; there may be one or more occurrences
during an electrocardiographic recording.
C107100 PREMATURE Interpolated VE;Interpolated An electrocardiographic finding of a premature Interpolated Premature

VENTRICULAR COMPLEX VES;Interpolated ventricular complex which occurs between two Ventricular Complex by
INTERPOLATED VPC;Interpolated Ventricular normal QRS complexes which have normal timing; ECG Finding
Extra Beat;Premature there may be one or more occurrences during an
Ventricular Complexes electrocardiographic recording.
Interpolated
C102673 PREMATURE Multifocal VES;Multifocal An electrocardiographic finding of premature Multifocal Ventricular

VENTRICULAR VPCS;Multifocal Ventricular ventricular complexes which have two or more Premature Complex by
COMPLEXES MULTIFOCAL Extra Beats;Premature distinct morphologies, suggesting origin at more ECG Finding
Ventricular Complexes than one ventricular site.
Multifocal
C102725 PREMATURE Premature Ventricular An electrocardiographic finding of premature Unifocal Ventricular

VENTRICULAR Complexes Unifocal;Unifocal ventricular complexes which have a single distinct Premature Complex by
COMPLEXES UNIFOCAL VES;Unifocal VPCS;Unifocal morphology, suggesting origin at one ventricular ECG Finding
Ventricular Extra Beats site.
C71034 PROLONGED QT Prolonged QT;Prolonged QT An electrocardiographic finding in which the QT Prolonged QT Interval by
interval interval not corrected for heart rate is prolonged. ECG Finding
populations exist.
C116137 PROLONGED ST An electrocardiographic finding of a prolonged ST Prolonged ST Segment by

SEGMENT segment, resulting in a long QT interval, without ECG Finding
lengthening of the T wave duration.
C71094 Q AXIS, LEFT AXIS Left-axis deviation;Q Axis, Left An electrocardiographic finding of a frontal plane Q Axis Left Axis Deviation
DEVIATION axis deviation;QRS axis, left QRS axis from -30 to -90 degrees.
axis deviation
C71095 Q AXIS, RIGHT AXIS Q Axis, Right axis An electrocardiographic finding of a frontal plane Q Axis Right Axis
DEVIATION deviation;QRS axis, right axis QRS axis from +90 to +180 degrees. Deviation
deviation;Right-axis deviation
C90440 QRS COMPLEX QRS Complex Abnormality An electrocardiographic finding of a non-specific QRS Complex
ABNORMALITY abnormality of the QRS complex, which is atypical in Abnormality by ECG
shape, duration, amplitude, axis or polarity. Finding
C83817 QTC PROLONGATION QTc Prolongation An electrocardiographic finding in which the QTc Corrected Prolonged QT
interval corrected for heart rate is prolonged. Interval by ECG Finding
populations exist.
C107098 QTCB PROLONGATION PROLONGED QTcB An electrocardiographic finding in which the QT QTcB Prolongation
C107099 QTCF PROLONGATION PROLONGED QTcF An electrocardiographic finding in which the QT QTcF Prolongation
C114161 QUALITY PROBLEM NOT Unknown Quality Problem An electrocardiographic artifact or recording error Quality Problem Not
OTHERWISE SPECIFIED with unknown origin or which is not described Otherwise Specified by
otherwise. ECG Finding
C61395 R ON T PHENOMENON R on T phenomenon An electrocardiographic finding in which the R wave R On T Phenomenon by

of a premature ventricular complex occurs on top of ECG Finding
the T wave of the preceding beat.
page 708 of 1925

C120522 HESTRESC
Code Value
C90444 R WAVE NOTCHED R Wave Notched An electrocardiographic finding of an R wave variant R Wave Notched by ECG
in which there is a small deflection of the R wave, Finding
with changing polarity, within the QRS complex.
(NCI)
C102574 REPOLARIZATION Repolarization Abnormality An electrocardiographic finding of an abnormality of Ventricular Repolarization

ABNORMALITY T wave duration or morphology or of early Abnormality
repolarization.
C102706 REPOLARIZATION Repolarization Abnormality An electrocardiographic finding of ST depression and Repolarization

ABNORMALITY Secondary To Ventricular T wave inversion in the presence of increased QRS Abnormality Secondary
SECONDARY TO Hypertrophy;ST-T change due amplitude which are thought to be due to left To Ventricular
VENTRICULAR to ventricular hypertrophy ventricular hypertrophy. Hypertrophy
HYPERTROPHY
C71041 RIGHT ATRIAL P-pulmonale;Right Atrial An electrocardiographic finding suggesting P-pulmonale by ECG
ABNORMALITY Enlargement underlying hypertrophy or dilatation of the right Finding
diagnosis of right atrial abnormality may include a
peaked p wave greater than 2.5 millimeters in
amplitude in the inferior leads. (NCI)
C62270 RIGHT BUNDLE BRANCH Complete RBBB;Right bundle An electrocardiographic finding of a wide QRS Right Bundle Branch
BLOCK branch block;Right bundle- complex with evidence of delayed conduction to the Block by ECG Finding
branch block right ventricle, manifest by a widened initial portion
V6, I and aVL, and with QRS duration greater than
or equal to 120 ms. An RsR' complex is typically
present in leads V1 and V2.
C92235 RIGHT VENTRICULAR Right Ventricular Conduction An electrocardiographic finding in which there is Right Ventricular
CONDUCTION DELAY Delay;Right Ventricular Delay evidence that electrical transmission through the Conduction Delay by ECG
right ventricle is impaired with a maximal QRS Finding
duration of 110 ms and which does not meet the
criteria for Incomplete Right Bundle Branch Block.
C71077 RIGHT VENTRICULAR Right ventricular Hypertrophy An electrocardiographic finding suggestive of a Right Ventricular
HYPERTROPHY hypertrophied right ventricle, characterized by large Hypertrophy by ECG
R wave amplitudes in the right precordial leads and Finding
secondary findings of right atrial enlargement, right
axis deviation, and typical pattern of ST depression
and T wave inversion in the right precordial leads.
C92227 RSR PRIME RSR' An electrocardiographic finding in which there are RSR' by ECG Finding
two R waves, which are two deflections above the
baseline resulting from a single ventricular
depolarization. The first upward deflection in the
complex is the R wave. The S is the first downward
deflection. A second upward deflection is called the
R-prime wave.
C35519 SEPTAL MYOCARDIAL Septal myocardial infarction An electrocardiographic finding suggesting an Septal Myocardial
INFARCTION infarction in the anatomic location of the cardiac Infarction by ECG Finding
septum. (NCI)
C62246 SHORT PR INTERVAL Short PR interval An electrocardiographic finding of an abnormally Short PR Interval by ECG
short PR interval. Thresholds for different age, Finding
C102709 SHORT QTC INTERVAL Short QTc Interval An electrocardiographic finding of a QT interval Short QTc Interval
corrected for heart rate that is shorter than the
lower limit of normal. Thresholds for different age,
C112402 SHORT QTCB An electrocardiographic finding in which the QT QTcB Shortened

C112403 SHORT QTCF An electrocardiographic finding in which the QT QTcF Shortened

C116136 SHORT ST SEGMENT An electrocardiographic finding of a short or absent Short ST Segment by

ST segment, resulting in a short QT interval, without ECG Finding
changes in T wave morphology.
C50553 SINOATRIAL EXIT BLOCK SA Block;Sinoatrial An electrocardiographic finding in which impaired Exit Block by ECG Finding
Block;Sinoatrial exit block conduction or automaticity within the sinus node
results in the failure of impulse transmission from
the sinoatrial node. This is manifest as dropped P
waves during sinus rhythm.
page 709 of 1925

C120522 HESTRESC
Code Value
C62242 SINUS ARREST/PAUSE Sinus arrest/pause;Sinus An electrocardiographic finding in which a failure of Sinus Arrest by ECG
pause or arrest impulse formation or conduction in the sinus node Finding
produces prolongation of the P-P interval or dropped
P waves. The threshold for the prolongation of the
P-P interval is not well defined.
C62239 SINUS ARRHYTHMIA Respiratory Sinus An electrocardiographic finding in which the sinus Sinus Arrhythmia by ECG
Arrhythmia;Sinus arrhythmia rate fluctuates with the respiratory cycle. Finding
C111097 SINUS BRADYCARDIA Sinus bradycardia An electrocardiographic finding of abnormally slow Sinus Bradycardia by ECG
populations exist.
C100076 SINUS RHYTHM Sinus Rhythm An electrocardiographic finding of an atrial rhythm Sinus Rhythm
considered normal for the population.
C120617 SINUS SLOWING WITH An electrocardiographic finding in which slowing of Sinus Slowing With AV
AV BLOCK the sinus rate and AV block occur simultaneously. Block by ECG Finding
C111104 SINUS TACHYCARDIA Sinus tachycardia An electrocardiographic finding of abnormally rapid Sinus Tachycardia by ECG
populations exist.
C41330 ST DEPRESSION ST depression An electrocardiographic finding of ST segment ST Segment Depression

depression below the baseline, often described as by ECG Finding
up sloping, down sloping or horizontal. (NCI)
C50540 ST ELEVATION ST elevation An electrocardiographic finding of ST segment ST Segment Elevation by

elevation above the baseline. (NCI) ECG Finding
C71029 ST ELEVATION ST elevation pericarditis An electrocardiographic finding of ST elevation ST Elevation Pericarditis

PERICARDITIS which is concave upwards, and which is often by ECG Finding
accompanied by PR segment depression.
C119252 SUPRAVENTRICULAR An electrocardiographic finding in which two Supraventricular Couplet

COUPLET premature atrial complexes occur sequentially. by ECG Finding
C135395 SUPRAVENTRICULAR Supraventricular Escape An electrocardiographic finding of a compensatory Supraventricular Escape

ESCAPE BEAT Complex;Supraventricular supraventricular complex that occurs following a Beat by ECG Finding
Escape Complexes prolonged RR interval.
C142246 SUPRAVENTRICULAR Supraventricular Premature An electrocardiographic finding of an ectopic impulse Supraventricular

PREMATURE COMPLEX, Complexes, Origin Unknown originating from the atria or AV junction for which Premature Complex With
ORIGIN UNKNOWN the site of origin cannot be determined from the Unknown Origin by ECG
surface electrocardiographic recording; there may Finding
be one or more occurrences during an
C120618 SUPRAVENTRICULAR RUN An electrocardiographic finding of three or more Supraventricular Run by

consecutive beats of supraventricular origin without ECG Finding
reference to rate.
C111100 SUPRAVENTRICULAR Supraventricular tachycardia An electrocardiographic finding of a tachycardia Supraventricular

TACHYCARDIA which does not originate in the ventricles or His Tachycardia by ECG
Purkinje system. There is an abnormally high heart Finding
rate and QRS complexes are typically narrow, but

INTERPRETATION suspected, but for which an interpretation is Interpretation Assumes
ASSUMES NO REVERSAL performed as though the lead placement is correct. No Reversal by ECG
Finding

INTERPRETATION suspected, and for which an interpretation is Interpretation Assumes
ASSUMES REVERSAL performed as though the leads have in fact been Reversal by ECG Finding
interchanged.
C120619 SUSTAINED An electrocardiographic finding of a supraventricular Sustained

SUPRAVENTRICULAR tachycardia with duration greater than 30 seconds Supraventricular
TACHYCARDIA (though other duration thresholds may be applied). Tachycardia by ECG
Finding
C71052 SUSTAINED Sustained ventricular An electrocardiographic finding of ventricular Sustained Ventricular

VENTRICULAR tachycardia tachycardia greater than 30 seconds in duration. Tachycardia by ECG
TACHYCARDIA (NCI) Finding
page 710 of 1925

C120522 HESTRESC
Code Value
C102718 T WAVE ALTERNANS T Wave Alternans An electrocardiographic finding in which there are T Wave Alternans by ECG
variations in the shape, amplitude, or direction of Finding
the T wave from one beat to the next.
C71085 T WAVE INVERSION T Wave Inversion An electrocardiographic finding of an inversion of T Wave Inversion by ECG
the T wave from the expected axis. (NCI) Finding
C71086 T WAVE PEAKED T wave peaked An electrocardiographic finding in which the T wave T Wave Peaked by ECG
appears increased in amplitude and cresting at a Finding
point. (NCI)
C71087 T WAVES BIPHASIC T waves biphasic An electrocardiographic finding of a T wave with T Waves Biphasic by ECG
both positive and negative components. Finding
C71088 T WAVES FLAT T waves flat An electrocardiographic finding in which the T wave T Waves Flat by ECG
appears decreased in amplitude. (NCI) Finding
C111121 TACHYCARDIA Tachycardia An electrocardiographic finding of abnormally rapid Tachycardia by ECG

C50779 TORSADES DE POINTES Torsades de An electrocardiographic finding of an atypical rapid Torsades De Pointes by
pointes;Ventricular polymorphic ventricular tachycardia with a ECG Finding
tachycardia, torsades de characteristic rotation of the QRS complex around
pointes the isoelectric baseline, occurring in the setting of a
prolonged QT interval. In addition, the QRS complex
displays a periodic waxing and waning of amplitude
on the electrogram.
C106579 U WAVE ABNORMALITY Abnormal U Wave An electrocardiographic finding of U waves which U Wave Abnormality by
have increased amplitude, are inverted, or merged ECG Finding
with the preceding T wave.
C116131 UNDETERMINED RHYTHM An electrocardiographic finding of a cardiac rhythm Undetermined Rhythm by

whose mechanism cannot be determined from the ECG Finding
ECG.
C120607 UNDETERMINED An electrocardiographic finding of a rhythm which Undetermined

SUPRAVENTRICULAR does not originate in the ventricles or His Purkinje Supraventricular Rhythm
RHYTHM system, but whose specific electrophysiologic by ECG Finding
mechanism cannot be determined from the ECG.
The QRS complexes are typically narrow, but
C71054 VENTRICULAR BIGEMINY Bigeminy An electrocardiographic finding of a normal QRS Ventricular Bigeminy by
complex followed by a premature ventricular ECG Finding
C62259 VENTRICULAR COUPLET Ventricular An electrocardiographic finding in which two Ventricular Couplet by
Couplets;Ventricular Pair premature ventricular complexes occur sequentially; ECG Finding
C90483 VENTRICULAR ESCAPE Ventricular Escape An electrocardiographic finding of a compensatory Ventricular Escape Beat
BEAT Beats;Ventricular Escape ventricular complex that occurs following a by ECG Finding
Complex;Ventricular Escape prolonged RR interval; there may be one or more
Complexes occurrences during an electrocardiographic
recording.
C111102 VENTRICULAR Ventricular fibrillation An electrocardiographic finding of a rapid grossly Ventricular Fibrillation by
FIBRILLATION irregular ventricular rhythm with marked variability ECG Finding
in QRS cycle length, morphology, and amplitude.
The rate is typically greater than 300 bpm.
C111115 VENTRICULAR FLUTTER Ventricular flutter A ventricular tachyarrhythmia characterized by a Ventricular Flutter by ECG
high ventricular rate (180 to 250 beats per minute) Finding
with a regular rhythm. The electrocardiogram shows
large oscillating sine wave-like complexes occurring
as a result of QRS complexes and T waves being
merged. The P wave is not visible. (NCI)
C102728 VENTRICULAR Parasystole;Ventricular An electrocardiographic finding of normal sinus Ventricular Parasystole by

PARASYSTOLE Parasystole rhythm coexisting with a regular ectopic ventricular ECG Finding
rhythm.
C120620 VENTRICULAR An electrocardiographic finding of three normal QRS Ventricular Quadrigeminy

QUADRIGEMINY complexes followed by a premature ventricular by ECG Finding
complex for three or more consecutive cycles; a
page 711 of 1925

C120522 HESTRESC
Code Value
C120621 VENTRICULAR RUN An electrocardiographic finding of three or more Ventricular Run by ECG
consecutive beats of ventricular origin without Finding
reference to rate.
C111103 VENTRICULAR Ventricular tachycardia An electrocardiographic finding of three or more Ventricular Tachycardia
TACHYCARDIA consecutive complexes of ventricular organ with a by ECG Finding
rate greater than a certain threshold (100 or 120
beats per minute are commonly used). The QRS
morphology.
C62234 VENTRICULAR Ventricular tachycardia, An electrocardiographic finding of a ventricular Monomorphic Ventricular

TACHYCARDIA, monomorphic tachycardia in which the QRS complexes have a Tachycardia by ECG
MONOMORPHIC uniform morphology. Finding
C62236 VENTRICULAR Ventricular tachycardia, An electrocardiographic finding of a ventricular Polymorphic Ventricular

TACHYCARDIA, polymorphic;Ventricular tachycardia in which the QRS complexes have a Tachycardia by ECG
POLYMORPHIC tachycardia, polymorphous variable morphology and often rate. Finding
C71055 VENTRICULAR Trigeminy An electrocardiographic finding of two normal QRS Ventricular Trigeminy by
TRIGEMINY complexes followed by a premature ventricular ECG Finding
C130067 VOLTAGE CRITERIA An electrocardiographic finding of large QRS Voltage Criteria

SUGGESTING LEFT amplitudes which may indicate left ventricular Suggesting Left
VENTRICULAR hypertrophy, but in the absence of any of the Ventricular Hypertrophy,
HYPERTROPHY, WITHOUT secondary findings which are typical of this Without Secondary ECG
SECONDARY ECG diagnosis (left atrial enlargement, left axis Findings
FINDINGS deviation, or typical pattern of ST depression and T
wave inversion).
C62240 WANDERING ATRIAL Wandering atrial pacemaker An electrocardiographic finding of a supraventricular Wandering Atrial
PACEMAKER arrhythmia characterized by 3 or more distinct P Pacemaker by ECG
rhythm. The ventricular rate is typically below 100
beats per minute.
C71090 WIDE QRS TACHYCARDIA Wide QRS tachycardia;Wide- An electrocardiographic finding of three or more Wide QRS Tachycardia by
QRS tachycardia consecutive wide QRS complexes of uncertain origin ECG Finding
with a rate greater than a certain threshold (100 or
120 beats per minute are commonly used).
C35132 WOLFF-PARKINSON- WPW;Wolff-Parkinson-White An electrocardiographic finding of ventricular pre- Wolff-Parkinson-White

WHITE SYNDROME syndrome excitation. The syndrome is characterized by a short Syndrome
PR interval and a long QRS interval with a delta
wave.
page 712 of 1925

HETEST (Holter ECG Test Name)
C120524 HETEST
Code Value
C111131 Atrioventricular Atrioventricular An electrocardiographic assessment of cardiac Atrioventricular

Conduction Conduction atrioventricular conduction. Conduction ECG
Assessment
C111132 Axis and Voltage Axis and Voltage An electrocardiographic assessment of mean cardiac Axis and Voltage ECG
C111155 Chamber Hypertrophy or Chamber Hypertrophy or An electrocardiographic assessment of chamber Chamber Hypertrophy or
Enlargement Enlargement hypertrophy or enlargement. Enlargement ECG
Assessment
C117761 Comparison to a Prior Comparison to a Prior A comparative interpretation of an ECG relative to a Comparison to a Prior
ECG ECG previous (comparator) ECG. The definition of the ECG
deteriorated.

formal language.
C111238 Intraventricular- Intraventricular- An electrocardiographic assessment of intraventricular Intraventricular and

Intraatrial Conduction Intraatrial Conduction and intra-atrial conduction. Intraatrial Conduction
ECG Assessment
C111280 Myocardial Infarction Myocardial Infarction An electrocardiographic assessment of findings suggestive Myocardial Infarction ECG
C111285 Pacemaker Pacemaker An electrocardiographic assessment of presence of Pacemaker ECG

C111307 Rhythm Not Otherwise Rhythm Not Otherwise An electrocardiographic assessment of cardiac rhythm not Rhythm Not Otherwise
Specified Specified otherwise specified. Specified ECG
Assessment
C111312 Sinus Node Rhythms and Sinus Node Rhythms and An electrocardiographic assessment of sinus node Sinus Node Rhythm and
Arrhythmias Arrhythmias rhythms and arrhythmias. Arrhythmia ECG
Assessment
C111363 ST Segment, T wave, and ST Segment, T wave, and An electrocardiographic assessment of the characteristics ST Segment, T wave, and
U wave U wave of the ST segment, T wave, and U wave. U wave ECG Assessment

Arrhythmias Arrhythmias arrhythmias excluding tachycardias. Arrhythmia ECG
Assessment

Assessment
C117807 Technical Quality Technical Quality A statement about an electrocardiographic recording ECG Technical Quality
C111330 Ventricular Arrhythmias Ventricular Arrhythmias An electrocardiographic assessment of ventricular Ventricular Arrhythmia
C111331 Ventricular Ventricular An electrocardiographic assessment of ventricular Ventricular

Assessment
page 713 of 1925

HETESTCD (Holter ECG Test Code)
C120523 HETESTCD
Code Value
C111131 AVCOND Atrioventricular An electrocardiographic assessment of cardiac Atrioventricular

Conduction atrioventricular conduction. Conduction ECG
Assessment
C111132 AXISVOLT Axis and Voltage An electrocardiographic assessment of mean cardiac Axis and Voltage ECG
C111155 CHYPTENL Chamber Hypertrophy or An electrocardiographic assessment of chamber Chamber Hypertrophy or

Enlargement hypertrophy or enlargement. Enlargement ECG
Assessment
C117761 EGCOMP Comparison to a Prior A comparative interpretation of an ECG relative to a Comparison to a Prior
ECG previous (comparator) ECG. The definition of the ECG
deteriorated.

formal language.
C111238 IVTIACD Intraventricular- An electrocardiographic assessment of intraventricular Intraventricular and

Intraatrial Conduction and intra-atrial conduction. Intraatrial Conduction
ECG Assessment
C111280 MI Myocardial Infarction An electrocardiographic assessment of findings suggestive Myocardial Infarction ECG
C111285 PACEMAKR Pacemaker An electrocardiographic assessment of presence of Pacemaker ECG

C111307 RHYNOS Rhythm Not Otherwise An electrocardiographic assessment of cardiac rhythm not Rhythm Not Otherwise
Specified otherwise specified. Specified ECG
Assessment
C111312 SNRARRY Sinus Node Rhythms and An electrocardiographic assessment of sinus node Sinus Node Rhythm and
Arrhythmias rhythms and arrhythmias. Arrhythmia ECG
Assessment
C111320 SPRARRY Supraventricular An electrocardiographic assessment of supraventricular Supraventricular

Arrhythmias arrhythmias excluding tachycardias. Arrhythmia ECG
Assessment
C111321 SPRTARRY Supraventricular An electrocardiographic assessment of supraventricular Supraventricular

Assessment
C111363 STSTWUW ST Segment, T wave, and An electrocardiographic assessment of the characteristics ST Segment, T wave, and
U wave of the ST segment, T wave, and U wave. U wave ECG Assessment
C117807 TECHQUAL Technical Quality A statement about an electrocardiographic recording ECG Technical Quality
C111330 VTARRY Ventricular Arrhythmias An electrocardiographic assessment of ventricular Ventricular Arrhythmia

C111331 VTTARRY Ventricular An electrocardiographic assessment of ventricular Ventricular

Assessment
page 714 of 1925

HSB01TC (HAS-BLED Bleeding Risk Score Clinical Classification Test Code)
C138213 HSB01TC
Code Value
C138357 HSB0101 HSB01-Hypertension HAS-BLED Bleeding Risk Score - Hypertension. HAS-BLED - Hypertension
C138358 HSB0102 HSB01-Abnormal Renal HAS-BLED Bleeding Risk Score - Abnormal renal and liver HAS-BLED - Abnormal
and Liver Function function. Renal and Liver Function
C138359 HSB0103 HSB01-Stroke HAS-BLED Bleeding Risk Score - Stroke. HAS-BLED - Stroke
C138360 HSB0104 HSB01-Bleeding HAS-BLED Bleeding Risk Score - Bleeding. HAS-BLED - Bleeding
C138361 HSB0105 HSB01-Labile INRs HAS-BLED Bleeding Risk Score - Labile INRs. HAS-BLED - Labile INRs
C138362 HSB0106 HSB01-Elderly HAS-BLED Bleeding Risk Score - Elderly. HAS-BLED - Elderly
C138363 HSB0107 HSB01-Drugs or Alcohol HAS-BLED Bleeding Risk Score - Drugs or alcohol. HAS-BLED - Drugs or
Alcohol
page 715 of 1925

HSB01TN (HAS-BLED Bleeding Risk Score Clinical Classification Test Name)
C138212 HSB01TN
Code Value
C138358 HSB01-Abnormal Renal HSB01-Abnormal Renal HAS-BLED Bleeding Risk Score - Abnormal renal and liver HAS-BLED - Abnormal
and Liver Function and Liver Function function. Renal and Liver Function
C138360 HSB01-Bleeding HSB01-Bleeding HAS-BLED Bleeding Risk Score - Bleeding. HAS-BLED - Bleeding
C138363 HSB01-Drugs or Alcohol HSB01-Drugs or Alcohol HAS-BLED Bleeding Risk Score - Drugs or alcohol. HAS-BLED - Drugs or
Alcohol
C138362 HSB01-Elderly HSB01-Elderly HAS-BLED Bleeding Risk Score - Elderly. HAS-BLED - Elderly
C138357 HSB01-Hypertension HSB01-Hypertension HAS-BLED Bleeding Risk Score - Hypertension. HAS-BLED - Hypertension
C138361 HSB01-Labile INRs HSB01-Labile INRs HAS-BLED Bleeding Risk Score - Labile INRs. HAS-BLED - Labile INRs
C138359 HSB01-Stroke HSB01-Stroke HAS-BLED Bleeding Risk Score - Stroke. HAS-BLED - Stroke
page 716 of 1925

IDSC1TC (Inventory of Depressive Symptomatology Clinician-Rated Version Clinical Classification Test
Code)
C130247 IDSC1TC
Code Value
C130360 IDSC101 IDSC1-Sleep Onset Inventory of Depressive Symptomatology - Clinician- IDS-C - Sleep Onset
Insomnia Rated - Please circle one response to each item that best Insomnia
describes the patient for the last seven days: Sleep onset
insomnia.
C130361 IDSC102 IDSC1-Mid-Nocturnal Inventory of Depressive Symptomatology - Clinician- IDS-C - Mid-Nocturnal

describes the patient for the last seven days: Mid-
nocturnal insomnia.
C130362 IDSC103 IDSC1-Early Morning Inventory of Depressive Symptomatology - Clinician- IDS-C - Early Morning
describes the patient for the last seven days: Early
morning insomnia.
C130363 IDSC104 IDSC1-Hypersomnia Inventory of Depressive Symptomatology - Clinician- IDS-C - Hypersomnia

Rated - Please circle one response to each item that best
describes the patient for the last seven days:
Hypersomnia.
C130364 IDSC105 IDSC1-Mood (Sad) Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood (Sad)
describes the patient for the last seven days: Mood
(sad).
C130365 IDSC106 IDSC1-Mood (Irritable) Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood (Irritable)
(irritable).
C130366 IDSC107 IDSC1-Mood (Anxious) Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood (Anxious)
(anxious).
C130367 IDSC108 IDSC1-Reactivity of Mood Inventory of Depressive Symptomatology - Clinician- IDS-C - Reactivity of
Rated - Please circle one response to each item that best Mood
describes the patient for the last seven days: Reactivity
of mood.
C130368 IDSC109 IDSC1-Mood Variation Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood Variation
variation.
C130369 IDSC109A IDSC1-Mood Worse Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood Worse in
Morn/Afternoon/Night Rated - Is mood typically worse in morning, afternoon, Morning, Afternoon, or
or night. Night
C130370 IDSC109B IDSC1-Mood Attributed to Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood Variation
Environment Rated - Is mood variation attributed to environment by Attributed to Environment
the patient?
C130371 IDSC110 IDSC1-Quality of Mood Inventory of Depressive Symptomatology - Clinician- IDS-C - Quality of Mood
describes the patient for the last seven days: Quality of
mood.
C130372 IDSC111 IDSC1-Appetite Inventory of Depressive Symptomatology - Clinician- IDS-C - Appetite

(Decreased) Rated - Please circle one response to each item that best (Decreased)
describes the patient for the last seven days: Appetite
(decreased).
C130373 IDSC112 IDSC1-Appetite Inventory of Depressive Symptomatology - Clinician- IDS-C - Appetite

(Increased) Rated - Please circle one response to each item that best (Increased)
describes the patient for the last seven days: Appetite
(increased).
C130374 IDSC113 IDSC1-Weight (Decrease) Inventory of Depressive Symptomatology - Clinician- IDS-C - Weight
Rated - Please circle one response to each item that best (Decrease)
describes the patient for the last seven days: Weight
(decrease) within the last two weeks.
C130375 IDSC114 IDSC1-Weight (Increase) Inventory of Depressive Symptomatology - Clinician- IDS-C - Weight
Rated - Please circle one response to each item that best (Increase)
describes the patient for the last seven days: Weight
(increase) within the last two weeks.
page 717 of 1925

C130247 IDSC1TC
Code Value
C130376 IDSC115 IDSC1- Inventory of Depressive Symptomatology - Clinician- IDS-C - Concentration or

Concentration/Decision Rated - Please circle one response to each item that best Decision Making
Making describes the patient for the last seven days:
Concentration/decision making.
C130377 IDSC116 IDSC1-Outlook (Self) Inventory of Depressive Symptomatology - Clinician- IDS-C - Outlook (Self)
describes the patient for the last seven days: Outlook
(self).
C130378 IDSC117 IDSC1-Outlook (Future) Inventory of Depressive Symptomatology - Clinician- IDS-C - Outlook (Future)
describes the patient for the last seven days: Outlook
(future).
C130379 IDSC118 IDSC1-Suicidal Ideation Inventory of Depressive Symptomatology - Clinician- IDS-C - Suicidal Ideation
describes the patient for the last seven days: Suicidal
ideation.
C130380 IDSC119 IDSC1-Involvement Inventory of Depressive Symptomatology - Clinician- IDS-C - Involvement

Involvement.
C130381 IDSC120 IDSC1- Inventory of Depressive Symptomatology - Clinician- IDS-C - Energy or

Energy/Fatiguability Rated - Please circle one response to each item that best Fatiguability
Energy/fatiguability.
C130382 IDSC121 IDSC1- Inventory of Depressive Symptomatology - Clinician- IDS-C - Pleasure or

Pleasure/Enjoyment Rated - Please circle one response to each item that best Enjoyment
(Exclude Sex) describes the patient for the last seven days:
Pleasure/enjoyment (exclude sexual activities).
C130383 IDSC122 IDSC1-Sexual Interest Inventory of Depressive Symptomatology - Clinician- IDS-C - Sexual Interest
describes the patient for the last seven days: Sexual
interest.
C130384 IDSC123 IDSC1-Psychomotor Inventory of Depressive Symptomatology - Clinician- IDS-C - Psychomotor

Slowing Rated - Please circle one response to each item that best Slowing
Psychomotor slowing.
C130385 IDSC124 IDSC1-Psychomotor Inventory of Depressive Symptomatology - Clinician- IDS-C - Psychomotor

Agitation Rated - Please circle one response to each item that best Agitation
Psychomotor agitation.
C130386 IDSC125 IDSC1-Somatic Inventory of Depressive Symptomatology - Clinician- IDS-C - Somatic

Complaints Rated - Please circle one response to each item that best Complaints
describes the patient for the last seven days: Somatic
complaints.
C130387 IDSC126 IDSC1-Sympathetic Inventory of Depressive Symptomatology - Clinician- IDS-C - Sympathetic

Arousal Rated - Please circle one response to each item that best Arousal
Sympathetic arousal.
C130388 IDSC127 IDSC1-Panic/Phobic Inventory of Depressive Symptomatology - Clinician- IDS-C - Panic or Phobic
Symptoms Rated - Please circle one response to each item that best Symptoms
Panic/phobic symptoms.
C130389 IDSC128 IDSC1-Gastrointestinal Inventory of Depressive Symptomatology - Clinician- IDS-C - Gastrointestinal

Gastrointestinal.
C130390 IDSC129 IDSC1-Interpersonal Inventory of Depressive Symptomatology - Clinician- IDS-C - Interpersonal

Sensitivity Rated - Please circle one response to each item that best Sensitivity
Interpersonal sensitivity.
C130391 IDSC130 IDSC1-Leaden Inventory of Depressive Symptomatology - Clinician- IDS-C - Leaden Paralysis
Paralysis/Physical Energy Rated - Please circle one response to each item that best or Physical Energy
describes the patient for the last seven days: Leaden
paralysis/physical energy.
C130392 IDSC131 IDSC1-Score Inventory of Depressive Symptomatology - Clinician- IDS-C - Score

Rated - Score.
page 718 of 1925

IDSC1TN (Inventory of Depressive Symptomatology Clinician-Rated Version Clinical Classification Test
Name)
C130246 IDSC1TN
Code Value
C130372 IDSC1-Appetite IDSC1-Appetite Inventory of Depressive Symptomatology - Clinician- IDS-C - Appetite

(Decreased) (Decreased) Rated - Please circle one response to each item that (Decreased)
best describes the patient for the last seven days:
Appetite (decreased).
C130373 IDSC1-Appetite IDSC1-Appetite Inventory of Depressive Symptomatology - Clinician- IDS-C - Appetite

(Increased) (Increased) Rated - Please circle one response to each item that (Increased)
Appetite (increased).
C130376 IDSC1- IDSC1- Inventory of Depressive Symptomatology - Clinician- IDS-C - Concentration or

Concentration/Decision Concentration/Decision Rated - Please circle one response to each item that Decision Making
Making Making best describes the patient for the last seven days:
C130362 IDSC1-Early Morning IDSC1-Early Morning Inventory of Depressive Symptomatology - Clinician- IDS-C - Early Morning
Insomnia Insomnia Rated - Please circle one response to each item that Insomnia
best describes the patient for the last seven days: Early
morning insomnia.
C130381 IDSC1- IDSC1- Inventory of Depressive Symptomatology - Clinician- IDS-C - Energy or

Energy/Fatiguability Energy/Fatiguability Rated - Please circle one response to each item that Fatiguability
Energy/fatiguability.
C130389 IDSC1-Gastrointestinal IDSC1-Gastrointestinal Inventory of Depressive Symptomatology - Clinician- IDS-C - Gastrointestinal

Rated - Please circle one response to each item that
Gastrointestinal.
C130363 IDSC1-Hypersomnia IDSC1-Hypersomnia Inventory of Depressive Symptomatology - Clinician- IDS-C - Hypersomnia

Hypersomnia.
C130390 IDSC1-Interpersonal IDSC1-Interpersonal Inventory of Depressive Symptomatology - Clinician- IDS-C - Interpersonal

Sensitivity Sensitivity Rated - Please circle one response to each item that Sensitivity
Interpersonal sensitivity.
C130380 IDSC1-Involvement IDSC1-Involvement Inventory of Depressive Symptomatology - Clinician- IDS-C - Involvement

Involvement.
C130391 IDSC1-Leaden IDSC1-Leaden Inventory of Depressive Symptomatology - Clinician- IDS-C - Leaden Paralysis
Paralysis/Physical Energy Paralysis/Physical Energy Rated - Please circle one response to each item that or Physical Energy
Leaden paralysis/physical energy.
C130361 IDSC1-Mid-Nocturnal IDSC1-Mid-Nocturnal Inventory of Depressive Symptomatology - Clinician- IDS-C - Mid-Nocturnal

best describes the patient for the last seven days: Mid-
nocturnal insomnia.
C130366 IDSC1-Mood (Anxious) IDSC1-Mood (Anxious) Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood (Anxious)
best describes the patient for the last seven days: Mood
(anxious).
C130365 IDSC1-Mood (Irritable) IDSC1-Mood (Irritable) Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood (Irritable)
(irritable).
C130364 IDSC1-Mood (Sad) IDSC1-Mood (Sad) Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood (Sad)
(sad).
C130370 IDSC1-Mood Attributed to IDSC1-Mood Attributed to Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood Variation
Environment Environment Rated - Is mood variation attributed to environment by Attributed to Environment
the patient?
C130368 IDSC1-Mood Variation IDSC1-Mood Variation Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood Variation
variation.
page 719 of 1925

C130246 IDSC1TN
Code Value
C130369 IDSC1-Mood Worse IDSC1-Mood Worse Inventory of Depressive Symptomatology - Clinician- IDS-C - Mood Worse in
Morn/Afternoon/Night Morn/Afternoon/Night Rated - Is mood typically worse in morning, afternoon, Morning, Afternoon, or
or night. Night
C130378 IDSC1-Outlook (Future) IDSC1-Outlook (Future) Inventory of Depressive Symptomatology - Clinician- IDS-C - Outlook (Future)
Outlook (future).
C130377 IDSC1-Outlook (Self) IDSC1-Outlook (Self) Inventory of Depressive Symptomatology - Clinician- IDS-C - Outlook (Self)
Outlook (self).
C130388 IDSC1-Panic/Phobic IDSC1-Panic/Phobic Inventory of Depressive Symptomatology - Clinician- IDS-C - Panic or Phobic
Symptoms Symptoms Rated - Please circle one response to each item that Symptoms
Panic/phobic symptoms.
C130382 IDSC1- IDSC1- Inventory of Depressive Symptomatology - Clinician- IDS-C - Pleasure or

Pleasure/Enjoyment Pleasure/Enjoyment Rated - Please circle one response to each item that Enjoyment
(Exclude Sex) (Exclude Sex) best describes the patient for the last seven days:
Pleasure/enjoyment (exclude sexual activities).
C130385 IDSC1-Psychomotor IDSC1-Psychomotor Inventory of Depressive Symptomatology - Clinician- IDS-C - Psychomotor

Agitation Agitation Rated - Please circle one response to each item that Agitation
Psychomotor agitation.
C130384 IDSC1-Psychomotor IDSC1-Psychomotor Inventory of Depressive Symptomatology - Clinician- IDS-C - Psychomotor

Slowing Slowing Rated - Please circle one response to each item that Slowing
Psychomotor slowing.
C130371 IDSC1-Quality of Mood IDSC1-Quality of Mood Inventory of Depressive Symptomatology - Clinician- IDS-C - Quality of Mood
Quality of mood.
C130367 IDSC1-Reactivity of Mood IDSC1-Reactivity of Mood Inventory of Depressive Symptomatology - Clinician- IDS-C - Reactivity of
Rated - Please circle one response to each item that Mood
Reactivity of mood.
C130392 IDSC1-Score IDSC1-Score Inventory of Depressive Symptomatology - Clinician- IDS-C - Score

Rated - Score.
C130383 IDSC1-Sexual Interest IDSC1-Sexual Interest Inventory of Depressive Symptomatology - Clinician- IDS-C - Sexual Interest
Sexual interest.
C130360 IDSC1-Sleep Onset IDSC1-Sleep Onset Inventory of Depressive Symptomatology - Clinician- IDS-C - Sleep Onset
best describes the patient for the last seven days: Sleep
onset insomnia.
C130386 IDSC1-Somatic IDSC1-Somatic Inventory of Depressive Symptomatology - Clinician- IDS-C - Somatic

Complaints Complaints Rated - Please circle one response to each item that Complaints
Somatic complaints.
C130379 IDSC1-Suicidal Ideation IDSC1-Suicidal Ideation Inventory of Depressive Symptomatology - Clinician- IDS-C - Suicidal Ideation
Suicidal ideation.
C130387 IDSC1-Sympathetic IDSC1-Sympathetic Inventory of Depressive Symptomatology - Clinician- IDS-C - Sympathetic

Arousal Arousal Rated - Please circle one response to each item that Arousal
Sympathetic arousal.
C130374 IDSC1-Weight (Decrease) IDSC1-Weight (Decrease) Inventory of Depressive Symptomatology - Clinician- IDS-C - Weight
Rated - Please circle one response to each item that (Decrease)
Weight (decrease) within the last two weeks.
C130375 IDSC1-Weight (Increase) IDSC1-Weight (Increase) Inventory of Depressive Symptomatology - Clinician- IDS-C - Weight
Rated - Please circle one response to each item that (Increase)
Weight (increase) within the last two weeks.
page 720 of 1925

IDSR1TC (Inventory of Depressive Symptomatology Self-Report Version Questionnaire Test Code)
C130261 IDSR1TC
Code Value
C130551 IDSR101 IDSR1-Falling Asleep Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Falling Asleep
Please circle the one response to each item that best
describes you for the past seven days: Falling asleep.
C130552 IDSR102 IDSR1-Sleep During the Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Sleep During
Night Please circle the one response to each item that best the Night
describes you for the past seven days: Sleep during the
night.
C130553 IDSR103 IDSR1-Waking Up Too Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Waking Up Too
Early Please circle the one response to each item that best Early
describes you for the past seven days: Waking up too
early.
C130554 IDSR104 IDSR1-Sleeping Too Much Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Sleeping Too
Please circle the one response to each item that best Much
describes you for the past seven days: Sleeping too
much.
C130555 IDSR105 IDSR1-Feeling Sad Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Sad
describes you for the past seven days: Feeling sad.
C130556 IDSR106 IDSR1-Feeling Irritable Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Irritable
describes you for the past seven days: Feeling irritable.
C130557 IDSR107 IDSR1-Feeling Anxious or Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Anxious
Tense Please circle the one response to each item that best or Tense
describes you for the past seven days: Feeling anxious or
tense.
C130558 IDSR108 IDSR1-Your Mood to Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Response of
Good/Desired Events Please circle the one response to each item that best Your Mood to Good or
describes you for the past seven days: Response of your Desired Events
mood to good or desired events.
C130559 IDSR109 IDSR1-Mood in Relation to Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Mood in
Time of Day Please circle the one response to each item that best Relation to the Time of
describes you for the past seven days: Mood in relation Day
to the time of day.
C130560 IDSR109A IDSR1-Mood Worse Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Mood Worse in
Morn/Afternoon/Night Is your mood typically worse in the morning, afternoon Morning, Afternoon, or
or night? Night
C130561 IDSR109B IDSR1-Mood Attributed to Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Mood Variation
Environment Is your mood variation attributed to the environment? Attributed to Environment
C130562 IDSR110 IDSR1-Quality of Your Inventory of Depressive Symptomatology - Self-Report - IDS-SR - The Quality of
Mood Please circle the one response to each item that best Your Mood
describes you for the past seven days: The quality of
your mood.
C130563 IDSR111 IDSR1-Decreased Appetite Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Decreased
Please circle the one response to each item that best Appetite
describes you for the past seven days: Decreased
appetite.
C130564 IDSR112 IDSR1-Increased Appetite Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Increased
describes you for the past seven days: Increased
appetite.
C130565 IDSR113 IDSR1-Weight (Decrease) Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Weight
Please circle the one response to each item that best (Decrease)
describes you for the past seven days: within the last
two weeks: Weight (decrease).
C130566 IDSR114 IDSR1-Weight (Increase) Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Weight
Please circle the one response to each item that best (Increase)
two weeks: Weight (increase).
C130567 IDSR115 IDSR1- Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Concentration

Concentration/Decision Please circle the one response to each item that best or Decision Making
Making describes you for the past seven days:
page 721 of 1925

C130261 IDSR1TC
Code Value
C130568 IDSR116 IDSR1-View of Myself Inventory of Depressive Symptomatology - Self-Report - IDS-SR - View of Myself
describes you for the past seven days: View of myself.
C130569 IDSR117 IDSR1-View of My Future Inventory of Depressive Symptomatology - Self-Report - IDS-SR - View of My
Please circle the one response to each item that best Future
describes you for the past seven days: View of my
future.
C130570 IDSR118 IDSR1-Thoughts of Death Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Thoughts of
or Suicide Please circle the one response to each item that best Death or Suicide
describes you for the past seven days: Thoughts of death
or suicide.
C130571 IDSR119 IDSR1-General Interest Inventory of Depressive Symptomatology - Self-Report - IDS-SR - General Interest
describes you for the past seven days: General interest.
C130572 IDSR120 IDSR1-Energy Level Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Energy Level
describes you for the past seven days: Energy level.
C130573 IDSR121 IDSR1- Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Capacity for
Pleasure/Enjoyment Please circle the one response to each item that best Pleasure or Enjoyment
(Exclude Sex) describes you for the past seven days: Capacity for
pleasure or enjoyment (excluding sex).
C130574 IDSR122 IDSR1-Interest in Sex Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Interest in Sex
describes you for the past seven days: Interest in sex.
C130575 IDSR123 IDSR1-Feeling Slowed Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Slowed
Down Please circle the one response to each item that best Down
describes you for the past seven days: Feeling slowed
down.
C130576 IDSR124 IDSR1-Feeling Restless Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Restless
describes you for the past seven days: Feeling restless.
C130577 IDSR125 IDSR1-Aches and Pains Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Aches and Pains
describes you for the past seven days: Aches and pains.
C130578 IDSR126 IDSR1-Other Bodily Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Other Bodily
Symptoms Please circle the one response to each item that best Symptoms
describes you for the past seven days: Other bodily
symptoms.
C130579 IDSR127 IDSR1-Panic/Phobic Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Panic or Phobic
Symptoms Please circle the one response to each item that best Symptoms
describes you for the past seven days: Panic/phobic
symptoms.
C130580 IDSR128 IDSR1- Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Constipation or

Constipation/Diarrhea Please circle the one response to each item that best Diarrhea
describes you for the past seven days:
Constipation/diarrhea.
C130581 IDSR129 IDSR1-Interpersonal Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Interpersonal

Sensitivity Please circle the one response to each item that best Sensitivity
describes you for the past seven days: Interpersonal
sensitivity.
C130582 IDSR130 IDSR1-Leaden Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Leaden

Paralysis/Physical Energy Please circle the one response to each item that best Paralysis or Physical
describes you for the past seven days: Leaden Energy
C130583 IDSR131 IDSR1-Score Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Score

Score.
page 722 of 1925

IDSR1TN (Inventory of Depressive Symptomatology Self-Report Version Questionnaire Test Name)
C130260 IDSR1TN
Code Value
C130577 IDSR1-Aches and Pains IDSR1-Aches and Pains Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Aches and Pains
describes you for the past seven days: Aches and pains.
C130567 IDSR1- IDSR1- Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Concentration

Concentration/Decision Concentration/Decision Please circle the one response to each item that best or Decision Making
Making Making describes you for the past seven days:
C130580 IDSR1- IDSR1- Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Constipation or

Constipation/Diarrhea Constipation/Diarrhea Please circle the one response to each item that best Diarrhea
describes you for the past seven days:
Constipation/diarrhea.
C130563 IDSR1-Decreased Appetite IDSR1-Decreased Appetite Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Decreased
describes you for the past seven days: Decreased
appetite.
C130572 IDSR1-Energy Level IDSR1-Energy Level Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Energy Level
describes you for the past seven days: Energy level.
C130551 IDSR1-Falling Asleep IDSR1-Falling Asleep Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Falling Asleep
describes you for the past seven days: Falling asleep.
C130557 IDSR1-Feeling Anxious or IDSR1-Feeling Anxious or Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Anxious
Tense Tense Please circle the one response to each item that best or Tense
describes you for the past seven days: Feeling anxious
or tense.
C130556 IDSR1-Feeling Irritable IDSR1-Feeling Irritable Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Irritable
describes you for the past seven days: Feeling irritable.
C130576 IDSR1-Feeling Restless IDSR1-Feeling Restless Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Restless
describes you for the past seven days: Feeling restless.
C130555 IDSR1-Feeling Sad IDSR1-Feeling Sad Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Sad
describes you for the past seven days: Feeling sad.
C130575 IDSR1-Feeling Slowed IDSR1-Feeling Slowed Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Feeling Slowed
Down Down Please circle the one response to each item that best Down
describes you for the past seven days: Feeling slowed
down.
C130571 IDSR1-General Interest IDSR1-General Interest Inventory of Depressive Symptomatology - Self-Report - IDS-SR - General Interest
describes you for the past seven days: General interest.
C130564 IDSR1-Increased Appetite IDSR1-Increased Appetite Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Increased
describes you for the past seven days: Increased
appetite.
C130574 IDSR1-Interest in Sex IDSR1-Interest in Sex Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Interest in Sex
describes you for the past seven days: Interest in sex.
C130581 IDSR1-Interpersonal IDSR1-Interpersonal Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Interpersonal

Sensitivity Sensitivity Please circle the one response to each item that best Sensitivity
describes you for the past seven days: Interpersonal
sensitivity.
C130582 IDSR1-Leaden IDSR1-Leaden Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Leaden

Paralysis/Physical Energy Paralysis/Physical Energy Please circle the one response to each item that best Paralysis or Physical
describes you for the past seven days: Leaden Energy
C130561 IDSR1-Mood Attributed to IDSR1-Mood Attributed to Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Mood Variation
Environment Environment Is your mood variation attributed to the environment? Attributed to Environment
C130559 IDSR1-Mood in Relation to IDSR1-Mood in Relation to Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Mood in
Time of Day Time of Day Please circle the one response to each item that best Relation to the Time of
describes you for the past seven days: Mood in relation Day
to the time of day.
page 723 of 1925

C130260 IDSR1TN
Code Value
C130560 IDSR1-Mood Worse IDSR1-Mood Worse Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Mood Worse in
Morn/Afternoon/Night Morn/Afternoon/Night Is your mood typically worse in the morning, afternoon Morning, Afternoon, or
or night? Night
C130578 IDSR1-Other Bodily IDSR1-Other Bodily Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Other Bodily
Symptoms Symptoms Please circle the one response to each item that best Symptoms
describes you for the past seven days: Other bodily
symptoms.
C130579 IDSR1-Panic/Phobic IDSR1-Panic/Phobic Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Panic or Phobic
Symptoms Symptoms Please circle the one response to each item that best Symptoms
describes you for the past seven days: Panic/phobic
symptoms.
C130573 IDSR1- IDSR1- Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Capacity for
Pleasure/Enjoyment Pleasure/Enjoyment Please circle the one response to each item that best Pleasure or Enjoyment
(Exclude Sex) (Exclude Sex) describes you for the past seven days: Capacity for
pleasure or enjoyment (excluding sex).
C130562 IDSR1-Quality of Your IDSR1-Quality of Your Inventory of Depressive Symptomatology - Self-Report - IDS-SR - The Quality of
Mood Mood Please circle the one response to each item that best Your Mood
describes you for the past seven days: The quality of
your mood.
C130583 IDSR1-Score IDSR1-Score Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Score

Score.
C130552 IDSR1-Sleep During the IDSR1-Sleep During the Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Sleep During
Night Night Please circle the one response to each item that best the Night
describes you for the past seven days: Sleep during the
night.
C130554 IDSR1-Sleeping Too Much IDSR1-Sleeping Too Much Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Sleeping Too
Please circle the one response to each item that best Much
describes you for the past seven days: Sleeping too
much.
C130570 IDSR1-Thoughts of Death IDSR1-Thoughts of Death Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Thoughts of
or Suicide or Suicide Please circle the one response to each item that best Death or Suicide
describes you for the past seven days: Thoughts of
death or suicide.
C130569 IDSR1-View of My Future IDSR1-View of My Future Inventory of Depressive Symptomatology - Self-Report - IDS-SR - View of My
Please circle the one response to each item that best Future
describes you for the past seven days: View of my
future.
C130568 IDSR1-View of Myself IDSR1-View of Myself Inventory of Depressive Symptomatology - Self-Report - IDS-SR - View of Myself
describes you for the past seven days: View of myself.
C130553 IDSR1-Waking Up Too IDSR1-Waking Up Too Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Waking Up Too
Early Early Please circle the one response to each item that best Early
describes you for the past seven days: Waking up too
early.
C130565 IDSR1-Weight (Decrease) IDSR1-Weight (Decrease) Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Weight
Please circle the one response to each item that best (Decrease)
two weeks: Weight (decrease).
C130566 IDSR1-Weight (Increase) IDSR1-Weight (Increase) Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Weight
Please circle the one response to each item that best (Increase)
two weeks: Weight (increase).
C130558 IDSR1-Your Mood to IDSR1-Your Mood to Inventory of Depressive Symptomatology - Self-Report - IDS-SR - Response of
Good/Desired Events Good/Desired Events Please circle the one response to each item that best Your Mood to Good or
describes you for the past seven days: Response of your Desired Events
mood to good or desired events.
page 724 of 1925

IECAT (Category for Inclusion/Exclusion)
C66797 IECAT
Code Value
C25370 EXCLUSION List of characteristics in a protocol, any one of which may Exclusion Criteria
exclude a potential subject from participation in a study.
(CDISC glossary)
C25532 INCLUSION The criteria in a protocol that prospective subjects must Inclusion Criteria
meet to be eligible for participation in a study. NOTE:
Exclusion and inclusion criteria define the study
population. See also exclusion criteria. (CDISC glossary)
page 725 of 1925

IIEF01TC (International Index of Erectile Function Questionnaire Test Code)
C103471 IIEF01TC
Code Value
C103587 IIEF0101 IIEF01-Erection During International Index of Erectile Function - Over the past IIEF - Able to Get an
Sexual Activity;IIEF01- four weeks how often were you able to get an erection Erection During Sexual
Erection Frequency during sexual activity? Activity
C103588 IIEF0102 IIEF01-Erection International Index of Erectile Function - Over the past IIEF - Erections Hard
Firmness;IIEF01-Erection four weeks when you had erections with sexual Enough for Penetration
Hard Enough to Penetrate stimulation, how often were your erections hard
enough for penetration?
C103589 IIEF0103 IIEF01-Able to Penetrate International Index of Erectile Function - Over the past IIEF - Able to Penetrate
Your Partner;IIEF01- four weeks when you attempted sexual intercourse, Your Partner
Penetration Ability how often were you able to penetrate (enter) your
partner?
C103590 IIEF0104 IIEF01-Maintain Erection International Index of Erectile Function - Over the past IIEF - Able to Maintain
After Penetrate;IIEF01- four weeks during sexual intercourse, how often were Your Erection After You
Maintenance Frequency you able to maintain your erection after you had Had Penetrated Your
penetrated (entered) your partner? Partner
C103591 IIEF0105 IIEF01-Maintain Erection to International Index of Erectile Function - Over the past IIEF - Maintain Your
Completion;IIEF01- four weeks during sexual intercourse, how difficult was Erection to Completion of
Maintenance Ability it to maintain your erection to completion of Intercourse
intercourse?
C103592 IIEF0106 IIEF01-Intercourse International Index of Erectile Function - Over the past IIEF - How Many Times
Frequency;IIEF01-Times four weeks how many times have you attempted sexual Have You Attempted
Attempted Sexual intercourse? Sexual Intercourse
Intercours
C103593 IIEF0107 IIEF01-How Often was it International Index of Erectile Function - Over the past IIEF - How Often was it
Satisfactory;IIEF01- four weeks when you attempted sexual intercourse, Satisfactory for You
Intercourse Satisfaction how often was it satisfactory for you?
C103594 IIEF0108 IIEF01-Enjoyed Sexual International Index of Erectile Function - Over the past IIEF - How Much Have
Intercourse;IIEF01- four weeks how much have you enjoyed sexual You Enjoyed Sexual
Intercourse Enjoyment intercourse? Intercourse
C103595 IIEF0109 IIEF01-Ejaculation International Index of Erectile Function - Over the past IIEF - How Often Did You
Frequency;IIEF01-How four weeks when you had sexual stimulation or Ejaculate
Often Did You Ejaculate intercourse, how often did you ejaculate?
C103596 IIEF0110 IIEF01-Did You Have International Index of Erectile Function - Over the past IIEF - Did You Have
Feeling of Orgasm;IIEF01- four weeks when you had sexual stimulation or Feeling of Orgasm With or
Orgasm Frequency intercourse, how often did you have the feeling of Without Ejaculation
orgasm with our without ejaculation?
C103597 IIEF0111 IIEF01-Desire International Index of Erectile Function - Over the past IIEF - How Often Have
Frequency;IIEF01-Have You four weeks how often have you felt sexual desire? You Felt Sexual Desire
Felt Sexual Desire
C103598 IIEF0112 IIEF01-Desire Level;IIEF01- International Index of Erectile Function - Over the past IIEF - Rate Your Level of
Rate Your Level of Sexual four weeks how would you rate your level of sexual Sexual Desire
Desire desire?
C103599 IIEF0113 IIEF01-Overall International Index of Erectile Function - Over the past IIEF - Satisfied with
Satisfaction;IIEF01- four weeks how satisfied have you been with your Overall Sex Life
Satisfied with Overall Sex overall sex life?
Life
C103600 IIEF0114 IIEF01-Relationship International Index of Erectile Function - Over the past IIEF - Satisfied with Your
Satisfaction;IIEF01-Satisfy four weeks how satisfied have you been with your Sexual Relationship with
with Sexual Relationship sexual relationship with your partner? Your Partner
C103601 IIEF0115 IIEF01-Confidence to International Index of Erectile Function - Over the past IIEF - Your Confidence to
Get/Keep Erection;IIEF01- four weeks how do you rate your confidence that you Get and Keep an Erection
Erection Confidence could get and keep an erection?
page 726 of 1925

IIEF01TN (International Index of Erectile Function Questionnaire Test Name)
C103470 IIEF01TN
Code Value
C103589 IIEF01-Able to Penetrate IIEF01-Able to Penetrate International Index of Erectile Function - Over the past IIEF - Able to Penetrate
Your Partner Your Partner;IIEF01- four weeks when you attempted sexual intercourse, Your Partner
Penetration Ability how often were you able to penetrate (enter) your
partner?
C103601 IIEF01-Confidence to IIEF01-Confidence to International Index of Erectile Function - Over the past IIEF - Your Confidence to
Get/Keep Erection Get/Keep Erection;IIEF01- four weeks how do you rate your confidence that you Get and Keep an Erection
Erection Confidence could get and keep an erection?
C103596 IIEF01-Did You Have IIEF01-Did You Have International Index of Erectile Function - Over the past IIEF - Did You Have
Feeling of Orgasm Feeling of Orgasm;IIEF01- four weeks when you had sexual stimulation or Feeling of Orgasm With or
Orgasm Frequency intercourse, how often did you have the feeling of Without Ejaculation
orgasm with our without ejaculation?
C103594 IIEF01-Enjoyed Sexual IIEF01-Enjoyed Sexual International Index of Erectile Function - Over the past IIEF - How Much Have
Intercourse Intercourse;IIEF01- four weeks how much have you enjoyed sexual You Enjoyed Sexual
Intercourse Enjoyment intercourse? Intercourse
C103587 IIEF01-Erection During IIEF01-Erection During International Index of Erectile Function - Over the past IIEF - Able to Get an
Sexual Activity Sexual Activity;IIEF01- four weeks how often were you able to get an erection Erection During Sexual
Erection Frequency during sexual activity? Activity
C103588 IIEF01-Erection Hard IIEF01-Erection International Index of Erectile Function - Over the past IIEF - Erections Hard
Enough to Penetrate Firmness;IIEF01-Erection four weeks when you had erections with sexual Enough for Penetration
Hard Enough to Penetrate stimulation, how often were your erections hard
enough for penetration?
C103597 IIEF01-Have You Felt IIEF01-Desire International Index of Erectile Function - Over the past IIEF - How Often Have
Sexual Desire Frequency;IIEF01-Have You four weeks how often have you felt sexual desire? You Felt Sexual Desire
Felt Sexual Desire
C103595 IIEF01-How Often Did IIEF01-Ejaculation International Index of Erectile Function - Over the past IIEF - How Often Did You
You Ejaculate Frequency;IIEF01-How four weeks when you had sexual stimulation or Ejaculate
Often Did You Ejaculate intercourse, how often did you ejaculate?
C103593 IIEF01-How Often was it IIEF01-How Often was it International Index of Erectile Function - Over the past IIEF - How Often was it
Satisfactory Satisfactory;IIEF01- four weeks when you attempted sexual intercourse, Satisfactory for You
Intercourse Satisfaction how often was it satisfactory for you?
C103590 IIEF01-Maintain Erection IIEF01-Maintain Erection International Index of Erectile Function - Over the past IIEF - Able to Maintain
After Penetrate After Penetrate;IIEF01- four weeks during sexual intercourse, how often were Your Erection After You
Maintenance Frequency you able to maintain your erection after you had Had Penetrated Your
penetrated (entered) your partner? Partner
C103591 IIEF01-Maintain Erection IIEF01-Maintain Erection to International Index of Erectile Function - Over the past IIEF - Maintain Your
to Completion Completion;IIEF01- four weeks during sexual intercourse, how difficult was Erection to Completion of
Maintenance Ability it to maintain your erection to completion of Intercourse
intercourse?
C103598 IIEF01-Rate Your Level of IIEF01-Desire Level;IIEF01- International Index of Erectile Function - Over the past IIEF - Rate Your Level of
Sexual Desire Rate Your Level of Sexual four weeks how would you rate your level of sexual Sexual Desire
Desire desire?
C103599 IIEF01-Satisfied with IIEF01-Overall International Index of Erectile Function - Over the past IIEF - Satisfied with
Overall Sex Life Satisfaction;IIEF01- four weeks how satisfied have you been with your Overall Sex Life
Satisfied with Overall Sex overall sex life?
Life
C103600 IIEF01-Satisfy with IIEF01-Relationship International Index of Erectile Function - Over the past IIEF - Satisfied with Your
Sexual Relationship Satisfaction;IIEF01-Satisfy four weeks how satisfied have you been with your Sexual Relationship with
with Sexual Relationship sexual relationship with your partner? Your Partner
C103592 IIEF01-Times Attempted IIEF01-Intercourse International Index of Erectile Function - Over the past IIEF - How Many Times
Sexual Intercours Frequency;IIEF01-Times four weeks how many times have you attempted sexual Have You Attempted
Attempted Sexual intercourse? Sexual Intercourse
Intercours
page 727 of 1925

INTMODEL (Intervention Model Response)
C99076 INTMODEL
Code Value
C82637 CROSS-OVER Participants receive one of two or more alternative Crossover Study
intervention(s) during the initial epoch of the study and
receive other intervention(s) during the subsequent
epoch(s) of the study.
C82638 FACTORIAL Two or more interventions, each alone or in combination, Factorial Study
are evaluated in parallel against a control group. This
study design allows for the comparison of active drug to
placebo, presence of drug-drug interactions, and
comparison of active drugs against each other.
C82639 PARALLEL Participants are assigned to one of two or more treatment Parallel Study
groups in parallel for the duration of the study.
C142568 SEQUENTIAL Groups of participants are assigned to receive Group Sequential Design
interventions based on prior milestones being reached in
the study. (clinicaltrials.gov)
C82640 SINGLE GROUP All trial participants are assigned to a single treatment Single Group Study
group for the duration of the study.
page 728 of 1925

INTTYPE (Intervention Type Response)
C99078 INTTYPE
Code Value
C15184 BEHAVIORAL THERAPY A technique used to change subjects' behavior, for Behavioral Intervention
example, psychotherapy, lifestyle counseling or hypnosis.
C307 BIOLOGIC A substance made from living organisms or things they Biological Agent
produce, for example: virus, therapeutic serum, toxin,
antitoxin, vaccine, blood, blood component or derivative,
allergenic product, or analogous product.
C16830 DEVICE An instrument, apparatus, implement, machine, Medical Device

contrivance, implant, in vitro reagent, or other similar or
related article, including any component, part, or
accessory, which is recognized in the official National
Formulary, or the United States Pharmacopeia, or any
supplement to them, intended for use in the diagnosis of
disease or other conditions, or in the cure, mitigation,
treatment, or prevention of disease, in man or other
animals, or intended to affect the structure or any
function of the body of man or other animals, and which
does not achieve its primary intended purposes through
chemical action within or on the body of man or other
animals and which is not dependent upon being
metabolized for the achievement of its primary intended
purposes. (FDA)
C1505 DIETARY SUPPLEMENT Oral preparations containing dietary ingredient(s) Dietary Supplement
intended to supplement the diet. Dietary ingredients
include vitamins, minerals, herbs, amino acids, extracts
and metabolites.
C1909 DRUG An active natural, synthetic or semi-synthetic ingredient Pharmacologic Substance

including endogenous body substance that is intended to
furnish pharmacological activity or other direct effect in
the diagnosis, cure, mitigation, treatment, or prevention
of disease or to affect the structure or any function of the
human body, but does not include intermediates used in
the synthesis of such ingredient (21 CFR 314.3(b)).
C15238 GENETIC Application of genetic material into cells in order to Gene Therapy
correct an inherited or acquired disease.
C17649 OTHER Other Different than the one(s) previously specified or Other
mentioned. (NCI)
C98769 PROCEDURE A treatment procedure performed by manual and/or Physical Medical

instrumental means, for example: surgery, lithotripsy, or Procedure
external manipulation.
C15313 RADIATION Radiation Therapy Treatment of a disease by means of exposure of the Radiation Therapy
target or the whole body to radiation.
page 729 of 1925

IPAQ01TC (International Physical Activity Questionnaire (August 2002) Short Last 7 Days Telephone
Format Questionnaire Test Code)
C141671 IPAQ01TC
Code Value
C141848 IPA0101 IPA01-Days Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Physical Activities 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do vigorous - Days Vigorous Physical
physical activities? Activities
C141849 IPA0102A IPA01-Vigorous Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend doing vigorous physical - Vigorous Physical Hours
activities on one of those days?: Hours per day. per Day
C141850 IPA0102B IPA01-Vigorous Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend doing vigorous physical - Vigorous Physical
activities on one of those days?: Minutes per day. Minutes per Day
C141851 IPA0102C IPA01-Total Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Week 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time in total would you spend over the last 7 days doing - Total Vigorous Hours
vigorous physical activities?: Hours per week. per Week
C141852 IPA0102D IPA01-Total Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Week 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time in total would you spend over the last 7 days doing - Total Vigorous Minutes
vigorous physical activities?: Minutes per week. per Week
C141853 IPA0103 IPA01-Days Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Physical Activities 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate Physical
C141854 IPA0104A IPA01-Moderate Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend doing moderate physical - Moderate Physical Hours
C141855 IPA0104B IPA01-Moderate Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend doing moderate physical - Moderate Physical
C141856 IPA0104C IPA01-Total Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Week 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent over the last 7 days - Total Moderate Hours
doing moderate physical activities?: Hours per week. per Week
C141857 IPA0104D IPA01-Total Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Week 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent over the last 7 days - Total Moderate Minutes
doing moderate physical activities?: Minutes per week. per Week
C141858 IPA0105 IPA01-Days Walk at Least International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
10 Minutes 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you walk for at least - Days Walk at Least 10
10 minutes at a time? Minutes
C141859 IPA0106A IPA01-Walking Hours per International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend walking on one of those - Walking Hours per Day
days?: Hours per day.
C141860 IPA0106B IPA01-Walking Minutes International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend walking on one of those - Walking Minutes per
days?: Minutes per day. Day
C141861 IPA0106C IPA01-Total Walking International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Week 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent walking over the last - Total Walking Hours per
7 days?: Hours per week. Week
C141862 IPA0106D IPA01-Total Walking International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Week 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent walking over the last - Total Walking Minutes
7 days?: Minutes per week. per Week
C141863 IPA0107A IPA01-Sitting Hours per International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Weekday 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Hours per
on a weekday?: Hours per weekday. Weekday
page 730 of 1925

C141671 IPAQ01TC
Code Value
C141864 IPA0107B IPA01-Sitting Minutes per International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Weekday 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Minutes per
on a weekday?: Minutes per weekday. Weekday
C141865 IPA0107C IPA01-Total Sitting Hours International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
on Wednesday 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent sitting last - Total Sitting Hours on
Wednesday?: Hours on Wednesday. Wednesday
C141866 IPA0107D IPA01-Total Sitting International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes on Wednesday 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent sitting last - Total Sitting Minutes on
Wednesday?: Minutes on Wednesday. Wednesday
page 731 of 1925

IPAQ01TN (International Physical Activity Questionnaire (August 2002) Short Last 7 Days Telephone
Format Questionnaire Test Name)
C141670 IPAQ01TN
Code Value
C141853 IPA01-Days Moderate IPA01-Days Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Physical Activities Physical Activities 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate Physical
C141848 IPA01-Days Vigorous IPA01-Days Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Physical Activities Physical Activities 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do vigorous - Days Vigorous Physical
C141858 IPA01-Days Walk at Least IPA01-Days Walk at Least International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
10 Minutes 10 Minutes 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you walk for at least - Days Walk at Least 10
10 minutes at a time? Minutes
C141854 IPA01-Moderate Physical IPA01-Moderate Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Day Hours per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend doing moderate physical - Moderate Physical Hours
Minutes per Day Minutes per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend doing moderate physical - Moderate Physical
C141863 IPA01-Sitting Hours per IPA01-Sitting Hours per International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Weekday Weekday 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Hours per
on a weekday?: Hours per weekday. Weekday
C141864 IPA01-Sitting Minutes per IPA01-Sitting Minutes per International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Weekday Weekday 2002) - Short Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Minutes per
on a weekday?: Minutes per weekday. Weekday
C141856 IPA01-Total Moderate IPA01-Total Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Week Hours per Week 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent over the last 7 days - Total Moderate Hours
doing moderate physical activities?: Hours per week. per Week
C141857 IPA01-Total Moderate IPA01-Total Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Week Minutes per Week 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent over the last 7 days - Total Moderate Minutes
doing moderate physical activities?: Minutes per week. per Week
C141865 IPA01-Total Sitting Hours IPA01-Total Sitting Hours International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
on Wednesday on Wednesday 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent sitting last - Total Sitting Hours on
Wednesday?: Hours on Wednesday. Wednesday
C141866 IPA01-Total Sitting IPA01-Total Sitting International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes on Wednesday Minutes on Wednesday 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent sitting last - Total Sitting Minutes on
Wednesday?: Minutes on Wednesday. Wednesday
C141851 IPA01-Total Vigorous IPA01-Total Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Week Hours per Week 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time in total would you spend over the last 7 days doing - Total Vigorous Hours
vigorous physical activities?: Hours per week. per Week
C141852 IPA01-Total Vigorous IPA01-Total Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Week Minutes per Week 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time in total would you spend over the last 7 days doing - Total Vigorous Minutes
vigorous physical activities?: Minutes per week. per Week
C141861 IPA01-Total Walking IPA01-Total Walking International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Week Hours per Week 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent walking over the last - Total Walking Hours per
7 days?: Hours per week. Week
C141862 IPA01-Total Walking IPA01-Total Walking International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Week Minutes per Week 2002) - Short Last 7 Days Telephone Format - What is Telephone Format Version
the total amount of time you spent walking over the last - Total Walking Minutes
7 days?: Minutes per week. per Week
C141849 IPA01-Vigorous Physical IPA01-Vigorous Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Day Hours per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend doing vigorous physical - Vigorous Physical Hours
page 732 of 1925

C141670 IPAQ01TN
Code Value
Minutes per Day Minutes per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend doing vigorous physical - Vigorous Physical
C141859 IPA01-Walking Hours per IPA01-Walking Hours per International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Day Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend walking on one of those - Walking Hours per Day
days?: Hours per day.
C141860 IPA01-Walking Minutes IPA01-Walking Minutes International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
per Day per Day 2002) - Short Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend walking on one of those - Walking Minutes per
days?: Minutes per day. Day
page 733 of 1925

IPAQ02TC (International Physical Activity Questionnaire (November 2002) Long Last 7 Days
Telephone Format Questionnaire Test Code)
C141669 IPAQ02TC
Code Value
C141815 IPA0116 IPA02-Days Moderate in International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
the Garden/Yard 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate in the
activities in the garden or yard? Garden/Yard
C141779 IPA0201 IPA02-Currently Have Job International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
or Unpaid Work 2002) - Long Last 7 Days Telephone Format - Do you Telephone Format Version
currently have a job or do any unpaid work outside your - Currently Have Job or
home? Unpaid Work
C141780 IPA0202 IPA02-Days Vigorous as International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Part of Work 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do vigorous - Days Vigorous as Part of
physical activities as part of your work? Work
C141781 IPA0203A IPA02-Vigorous Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Hours per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days doing - Vigorous Work Hours
vigorous physical activities as part of your work?: Hours per Day
per day.
C141782 IPA0203B IPA02-Vigorous Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Minutes per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days doing - Vigorous Work Minutes
vigorous physical activities as part of your work?: Minutes per Day
per day.
C141783 IPA0203C IPA02-Vigorous Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Hours per Week 2002) - Long Last 7 Days Telephone Format - What is the Telephone Format Version
total amount of time you spent over the last 7 days doing - Vigorous Work Hours
vigorous physical activities as part of your work?: Hours per Week
per week.
C141784 IPA0203D IPA02-Vigorous Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Minutes per Week 2002) - Long Last 7 Days Telephone Format - What is the Telephone Format Version
total amount of time you spent over the last 7 days doing - Vigorous Work Minutes
vigorous physical activities as part of your work?: Minutes per Week
per week.
C141785 IPA0204 IPA02-Days Moderate as International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Part of Work 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate as Part
physical activities as part of your work? of Work
C141786 IPA0205A IPA02-Moderate Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Work Hours
moderate physical activities as part of your work?: Hours per Day
per day.
C141787 IPA0205B IPA02-Moderate Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Work Minutes
moderate physical activities as part of your work?: per Day
Minutes per day.
C141788 IPA0205C IPA02-Moderate Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Moderate Work Hours
moderate physical activities as part of your work?: Hours per Week
per week.
C141789 IPA0205D IPA02-Moderate Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Moderate Work Minutes
moderate physical activities as part of your work?: per Week
Minutes per week.
C141790 IPA0206 IPA02-Days Walk as Part International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
of Your Work 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you walk as part of - Days Walk as Part of
your work? Your Work
C141791 IPA0207A IPA02-Walking Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days walking - Walking Work Hours per
as part of your work?: Hours per day. Day
page 734 of 1925

C141669 IPAQ02TC
Code Value
C141792 IPA0207B IPA02-Walking Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days walking - Walking Work Minutes
as part of your work?: Minutes per day. per Day
C141793 IPA0207C IPA02-Walking Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent walking over the last 7 - Walking Work Hours per
days as part of your work?: Hours per week. Week
C141794 IPA0207D IPA02-Walking Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent walking over the last 7 - Walking Work Minutes
days as part of your work?: Minutes per week. per Week
C141795 IPA0208 IPA02-Days Travel in a International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Motor Vehicle 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you travel in a motor - Days Travel in a Motor
vehicle like a train, bus, car or tram? Vehicle
C141796 IPA0209A IPA02-Traveling Hours International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days traveling - Traveling Hours per Day
in a car, bus, train or other kind of motor vehicle?: Hours
per day.
C141797 IPA0209B IPA02-Traveling Minutes International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days traveling - Traveling Minutes per
in a car, bus, train or other kind of motor vehicle?: Day
Minutes per day.
C141798 IPA0209C IPA02-Traveling Hours International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
per Week 2002) - Long Last 7 Days Telephone Format - What is the Telephone Format Version
total amount of time you spent over the last 7 days - Traveling Hours per
traveling in a motor vehicle?: Hours per week. Week
C141799 IPA0209D IPa02-Traveling Minutes International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days - Traveling Minutes per
traveling in a motor vehicle?: Minutes per week. Week
C141800 IPA0210 IPA02-Days Bicycle Place International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
to Place 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you bicycle to go from - Days Bicycle Place to
place to place? Place
C141801 IPA0211A IPA02-Bicycle Hours per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days to - Bicycle Hours per Day
bicycle from place to place?: Hours per day.
C141802 IPA0211B IPA02-Bicycle Minutes per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days to - Bicycle Minutes per Day
bicycle from place to place?: Minutes per day.
C141803 IPA0211C IPA02-Bicycling Hours per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Week 2002) - Long Last 7 Days Telephone Format - What is the Telephone Format Version
total amount of time you spent bicycling over the last 7 - Bicycling Hours per
days to travel from place to place?: Hours per week. Week
C141804 IPA0211D IPA02-Bicycling Minutes International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent bicycling over the last 7 - Bicycling Minutes per
days to travel from place to place?: Minutes per week. Week
C141805 IPA0212 IPA02-Days Walk Place to International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Place 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you walk to go from - Days Walk Place to
C141806 IPA0213A IPA02-Walking Place International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days walking - Walking Place Hours per
from place to place?: Hours per day. Day
C141807 IPA0213B IPA02-Walking Place International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days walking - Walking Place Minutes
from place to place?: Minutes per day. per Day
page 735 of 1925

C141669 IPAQ02TC
Code Value
C141808 IPA0213C IPA02-Walking Place International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days - Walking Place Hours per
walking from place to place?: Hours per week. Week
C141809 IPA0213D IPA02-Walking Place International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days - Walking Place Minutes
walking from place to place?: Minutes per week. per Week
C141810 IPA0214 IPA02-Days Vigorous in International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
the Garden/Yard 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do vigorous - Days Vigorous in the
physical activities in the garden or yard? Garden/Yard
C141811 IPA0215A IPA02-Vigorous Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Vigorous Garden Hours
vigorous physical activities in the garden or yard?: Hours per Day
per day.
C141812 IPA0215B IPA02-Vigorous Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Vigorous Garden
vigorous physical activities in the garden or yard?: Minutes per Day
Minutes per day.
C141813 IPA0215C IPA02-Vigorous Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Vigorous Garden Hours
vigorous physical activities in the garden or yard?: Hours per Week
per week.
C141814 IPA0215D IPA02-Vigorous Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Vigorous Garden
vigorous physical activities in the garden or yard?: Minutes per Week
Minutes per week.
C141816 IPA0217A IPA02-Moderate Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Garden Hours
moderate physical activities in the garden or yard?: Hours per Day
per day.
C141817 IPA0217B IPA02-Moderate Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Garden
moderate physical activities in the garden or yard?: Minutes per Day
Minutes per day.
C141818 IPA0217C IPA02-Moderate Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Moderate Garden Hours
moderate physical activities in the garden or yard?: Hours per Week
per week.
C141819 IPA0217D IPA02-Moderate Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Moderate Garden
moderate physical activities in the garden or yard?: Minutes per Week
Minutes per week.
C141820 IPA0218 IPA02-Days Moderate International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Inside Your Home 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate Inside
activities inside your home? Your Home
C141821 IPA0219A IPA02-Moderate Home International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Home Hours
moderate physical activities inside your home?: Hours per per Day
day.
C141822 IPA0219B IPA02-Moderate Home International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Home Minutes
moderate physical activities inside your home?: Minutes per Day
per day.
C141823 IPA0219C IPA02-Moderate Home International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Moderate Home Hours
moderate physical activities inside your home?: Hours per per Week
week.
page 736 of 1925

C141669 IPAQ02TC
Code Value
C141824 IPA0219D IPA02-Moderate Home International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Moderate Home Minutes
moderate physical activities inside your home?: Minutes per Week
per week.
C141825 IPA0220 IPA02-Days Walk in Your International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Leisure Time 2002) - Long Last 7 Days Telephone Format - Not Telephone Format Version
counting any walking you have already mentioned, during - Days Walk in Your
the last 7 days, on how many days did you walk for at Leisure Time
least 10 minutes at a time in your leisure time?
C141826 IPA0221A IPA02-Walking Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days walking - Walking Leisure Hours
in your leisure time?: Hours per day. per Day
C141827 IPA0221B IPA02-Walking Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Minutes Per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days walking - Walking Leisure Minutes
in your leisure time?: Minutes per day. Per Day
C141828 IPA0221C IPA02-Walking Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days - Walking Leisure Hours
walking in your leisure time?: Hours per week. per Week
C141829 IPA0221D IPA02-Walking Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days - Walking Leisure Minutes
walking in your leisure time?: Minutes per week. per Week
C141830 IPA0222 IPA02-Days Vigorous in International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Your Leisure Time 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do vigorous - Days Vigorous in Your
physical activities in your leisure time? Leisure Time
C141831 IPA0223A IPA02-Vigorous Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Vigorous Leisure Hours
vigorous physical activities in your leisure time?: Hours per Day
per day.
C141832 IPA0223B IPA02-Vigorous Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Vigorous Leisure
vigorous physical activities in your leisure time?: Minutes Minutes per Day
per day.
C141833 IPA0223C IPA02-Vigorous Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Vigorous Leisure Hours
vigorous physical activities in your leisure time?: Hours per Week
per week.
C141834 IPA0223D IPA02-Vigorous Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Vigorous Leisure
vigorous physical activities in your leisure time?: Minutes Minutes per Week
per week.
C141835 IPA0224 IPA02-Days Moderate in International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Your Leisure Time 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate in Your
C141836 IPA0225A IPA02-Moderate Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Leisure Hours
moderate physical activities in your leisure time?: Hours per Day
per day.
C141837 IPA0225B IPA02-Moderate Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Leisure
moderate physical activities in your leisure time?: Minutes Minutes per Day
per day.
C141838 IPA0225C IPA02-Moderate Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Moderate Leisure Hours
moderate physical activities in your leisure time?: Hours per Week
per week.
page 737 of 1925

C141669 IPAQ02TC
Code Value
C141839 IPA0225D IPA02-Moderate Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days doing - Moderate Leisure
moderate physical activities in your leisure time? Minutes Minutes per Week
per week.
C141840 IPA0226A IPA02-Sitting Weekday International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Hours per Day 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Weekday Hours
on a weekday?: Hours per day. per Day
C141841 IPA0226B IPA02-Sitting Weekday International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Minutes per Day 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Weekday
on a weekday?: Minutes per day. Minutes per Day
C141842 IPA0226C IPA02-Sitting Hours on International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Wednesday 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time in total did you spend sitting on Wednesday?: Hours - Sitting Hours on
on Wednesday. Wednesday
C141843 IPA0226D IPA02-Sitting Minutes per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Wednesday 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time in total did you spend sitting on Wednesday?: - Sitting Minutes per
Minutes per Wednesday. Wednesday
C141844 IPA0227A IPA02-Sitting Weekend International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Hours per Day 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Weekend Hours
on a weekend day?: Hours per day. per Day
C141845 IPA0227B IPA02-Sitting Weekend International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Minutes per Day 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Weekend
on a weekend day?: Minutes per day. Minutes per Day
C141846 IPA0227C IPA02-Sitting Hours on International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Saturday 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time in total did you spend sitting on Saturday?: Hours on - Sitting Hours on
Saturday. Saturday
C141847 IPA0227D IPA02-Sitting Minutes per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Saturday 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time in total did you spend sitting on Saturday?: Minutes - Sitting Minutes per
per Saturday. Saturday
page 738 of 1925

IPAQ02TN (International Physical Activity Questionnaire (November 2002) Long Last 7 Days
Telephone Format Questionnaire Test Name)
C141668 IPAQ02TN
Code Value
C141801 IPA02-Bicycle Hours per IPA02-Bicycle Hours per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Day Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days to - Bicycle Hours per Day
bicycle from place to place?: Hours per day.
C141802 IPA02-Bicycle Minutes per IPA02-Bicycle Minutes per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Day Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days to - Bicycle Minutes per Day
bicycle from place to place?: Minutes per day.
C141803 IPA02-Bicycling Hours per IPA02-Bicycling Hours per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Week Week 2002) - Long Last 7 Days Telephone Format - What is the Telephone Format Version
total amount of time you spent bicycling over the last 7 - Bicycling Hours per
days to travel from place to place?: Hours per week. Week
C141804 IPA02-Bicycling Minutes IPA02-Bicycling Minutes International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
per Week per Week 2002) - Long Last 7 Days Telephone Format - What is the Telephone Format Version
total amount of time you spent bicycling over the last 7 - Bicycling Minutes per
days to travel from place to place?: Minutes per week. Week
C141779 IPA02-Currently Have Job IPA02-Currently Have Job International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
or Unpaid Work or Unpaid Work 2002) - Long Last 7 Days Telephone Format - Do you Telephone Format Version
currently have a job or do any unpaid work outside your - Currently Have Job or
home? Unpaid Work
C141800 IPA02-Days Bicycle Place IPA02-Days Bicycle Place International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
to Place to Place 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you bicycle to go from - Days Bicycle Place to
C141785 IPA02-Days Moderate as IPA02-Days Moderate as International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Part of Work Part of Work 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate as Part
physical activities as part of your work? of Work
C141815 IPA02-Days Moderate in IPA02-Days Moderate in International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
the Garden/Yard the Garden/Yard 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate in the
activities in the garden or yard? Garden/Yard
C141835 IPA02-Days Moderate in IPA02-Days Moderate in International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Your Leisure Time Your Leisure Time 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate in Your
C141820 IPA02-Days Moderate IPA02-Days Moderate International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Inside Your Home Inside Your Home 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do moderate - Days Moderate Inside
activities inside your home? Your Home
C141795 IPA02-Days Travel in a IPA02-Days Travel in a International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Motor Vehicle Motor Vehicle 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you travel in a motor - Days Travel in a Motor
vehicle like a train, bus, car or tram? Vehicle
C141780 IPA02-Days Vigorous as IPA02-Days Vigorous as International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Part of Work Part of Work 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do vigorous - Days Vigorous as Part of
physical activities as part of your work? Work
C141810 IPA02-Days Vigorous in IPA02-Days Vigorous in International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
the Garden/Yard the Garden/Yard 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do vigorous - Days Vigorous in the
physical activities in the garden or yard? Garden/Yard
C141830 IPA02-Days Vigorous in IPA02-Days Vigorous in International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Your Leisure Time Your Leisure Time 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you do vigorous - Days Vigorous in Your
C141790 IPA02-Days Walk as Part IPA02-Days Walk as Part International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
of Your Work of Your Work 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you walk as part of - Days Walk as Part of
your work? Your Work
page 739 of 1925

C141668 IPAQ02TN
Code Value
C141825 IPA02-Days Walk in Your IPA02-Days Walk in Your International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Leisure Time Leisure Time 2002) - Long Last 7 Days Telephone Format - Not Telephone Format Version
counting any walking you have already mentioned, during - Days Walk in Your
the last 7 days, on how many days did you walk for at Leisure Time
least 10 minutes at a time in your leisure time?
C141805 IPA02-Days Walk Place to IPA02-Days Walk Place to International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Place Place 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, on how many days did you walk to go from - Days Walk Place to
C141816 IPA02-Moderate Garden IPA02-Moderate Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Hours per Day Hours per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days doing - Moderate Garden Hours
moderate physical activities in the garden or yard?: Hours per Day
per day.
Hours per Week Hours per Week 2002) - Long Last 7 Days Telephone Format - What is the Telephone Format Version
total amount of time you spent over the last 7 days doing - Moderate Garden Hours
moderate physical activities in the garden or yard?: Hours per Week
per week.
Minutes per Day Minutes per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days doing - Moderate Garden
moderate physical activities in the garden or yard?: Minutes per Day
Minutes per day.
Minutes per Week Minutes per Week 2002) - Long Last 7 Days Telephone Format - What is the Telephone Format Version
total amount of time you spent over the last 7 days doing - Moderate Garden
moderate physical activities in the garden or yard?: Minutes per Week
Minutes per week.
C141821 IPA02-Moderate Home IPA02-Moderate Home International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Home Hours
moderate physical activities inside your home?: Hours per per Day
day.
total amount of time you spent over the last 7 days doing - Moderate Home Hours
moderate physical activities inside your home?: Hours per per Week
week.
time did you usually spend on one of those days doing - Moderate Home Minutes
moderate physical activities inside your home?: Minutes per Day
per day.
total amount of time you spent over the last 7 days doing - Moderate Home Minutes
moderate physical activities inside your home?: Minutes per Week
per week.
C141836 IPA02-Moderate Leisure IPA02-Moderate Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Leisure Hours
moderate physical activities in your leisure time?: Hours per Day
per day.
total amount of time you spent over the last 7 days doing - Moderate Leisure Hours
moderate physical activities in your leisure time?: Hours per Week
per week.
time did you usually spend on one of those days doing - Moderate Leisure
moderate physical activities in your leisure time?: Minutes Minutes per Day
per day.
total amount of time you spent over the last 7 days doing - Moderate Leisure
moderate physical activities in your leisure time? Minutes Minutes per Week
per week.
page 740 of 1925

C141668 IPAQ02TN
Code Value
C141786 IPA02-Moderate Work IPA02-Moderate Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Moderate Work Hours
moderate physical activities as part of your work?: Hours per Day
per day.
total amount of time you spent over the last 7 days doing - Moderate Work Hours
moderate physical activities as part of your work?: Hours per Week
per week.
time did you usually spend on one of those days doing - Moderate Work Minutes
moderate physical activities as part of your work?: per Day
Minutes per day.
total amount of time you spent over the last 7 days doing - Moderate Work Minutes
moderate physical activities as part of your work?: per Week
Minutes per week.
C141846 IPA02-Sitting Hours on IPA02-Sitting Hours on International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Saturday Saturday 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time in total did you spend sitting on Saturday?: Hours on - Sitting Hours on
Saturday. Saturday
C141842 IPA02-Sitting Hours on IPA02-Sitting Hours on International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Wednesday Wednesday 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time in total did you spend sitting on Wednesday?: Hours - Sitting Hours on
on Wednesday. Wednesday
C141847 IPA02-Sitting Minutes per IPA02-Sitting Minutes per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Saturday Saturday 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time in total did you spend sitting on Saturday?: Minutes - Sitting Minutes per
per Saturday. Saturday
C141843 IPA02-Sitting Minutes per IPA02-Sitting Minutes per International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Wednesday Wednesday 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time in total did you spend sitting on Wednesday?: - Sitting Minutes per
Minutes per Wednesday. Wednesday
C141840 IPA02-Sitting Weekday IPA02-Sitting Weekday International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Hours per Day Hours per Day 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Weekday Hours
on a weekday?: Hours per day. per Day
C141841 IPA02-Sitting Weekday IPA02-Sitting Weekday International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Minutes per Day Minutes per Day 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Weekday
on a weekday?: Minutes per day. Minutes per Day
C141844 IPA02-Sitting Weekend IPA02-Sitting Weekend International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Hours per Day Hours per Day 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Weekend Hours
on a weekend day?: Hours per day. per Day
C141845 IPA02-Sitting Weekend IPA02-Sitting Weekend International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
Minutes per Day Minutes per Day 2002) - Long Last 7 Days Telephone Format - During the Telephone Format Version
last 7 days, how much time did you usually spend sitting - Sitting Weekend
on a weekend day?: Minutes per day. Minutes per Day
C141796 IPA02-Traveling Hours IPA02-Traveling Hours International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
per Day per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days traveling - Traveling Hours per Day
in a car, bus, train or other kind of motor vehicle?: Hours
per day.
C141798 IPA02-Traveling Hours IPA02-Traveling Hours International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days - Traveling Hours per
traveling in a motor vehicle?: Hours per week. Week
C141797 IPA02-Traveling Minutes IPA02-Traveling Minutes International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
per Day per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days traveling - Traveling Minutes per
in a car, bus, train or other kind of motor vehicle?: Day
Minutes per day.
C141799 IPa02-Traveling Minutes IPa02-Traveling Minutes International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
total amount of time you spent over the last 7 days - Traveling Minutes per
traveling in a motor vehicle?: Minutes per week. Week
page 741 of 1925

C141668 IPAQ02TN
Code Value
C141811 IPA02-Vigorous Garden IPA02-Vigorous Garden International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Vigorous Garden Hours
vigorous physical activities in the garden or yard?: Hours per Day
per day.
total amount of time you spent over the last 7 days doing - Vigorous Garden Hours
vigorous physical activities in the garden or yard?: Hours per Week
per week.
time did you usually spend on one of those days doing - Vigorous Garden
vigorous physical activities in the garden or yard?: Minutes per Day
Minutes per day.
total amount of time you spent over the last 7 days doing - Vigorous Garden
vigorous physical activities in the garden or yard?: Minutes per Week
Minutes per week.
C141831 IPA02-Vigorous Leisure IPA02-Vigorous Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Vigorous Leisure Hours
vigorous physical activities in your leisure time?: Hours per Day
per day.
total amount of time you spent over the last 7 days doing - Vigorous Leisure Hours
vigorous physical activities in your leisure time?: Hours per Week
per week.
time did you usually spend on one of those days doing - Vigorous Leisure
vigorous physical activities in your leisure time?: Minutes Minutes per Day
per day.
total amount of time you spent over the last 7 days doing - Vigorous Leisure
vigorous physical activities in your leisure time?: Minutes Minutes per Week
per week.
C141781 IPA02-Vigorous Work IPA02-Vigorous Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days doing - Vigorous Work Hours
vigorous physical activities as part of your work?: Hours per Day
per day.
total amount of time you spent over the last 7 days doing - Vigorous Work Hours
vigorous physical activities as part of your work?: Hours per Week
per week.
time did you usually spend on one of those days doing - Vigorous Work Minutes
vigorous physical activities as part of your work?: Minutes per Day
per day.
total amount of time you spent over the last 7 days doing - Vigorous Work Minutes
vigorous physical activities as part of your work?: Minutes per Week
per week.
C141826 IPA02-Walking Leisure IPA02-Walking Leisure International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days walking - Walking Leisure Hours
in your leisure time?: Hours per day. per Day
total amount of time you spent over the last 7 days - Walking Leisure Hours
walking in your leisure time?: Hours per week. per Week
page 742 of 1925

C141668 IPAQ02TN
Code Value
Minutes Per Day Minutes Per Day 2002) - Long Last 7 Days Telephone Format - How much Telephone Format Version
time did you usually spend on one of those days walking - Walking Leisure Minutes
in your leisure time?: Minutes per day. Per Day
total amount of time you spent over the last 7 days - Walking Leisure Minutes
walking in your leisure time?: Minutes per week. per Week
C141806 IPA02-Walking Place IPA02-Walking Place International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days walking - Walking Place Hours per
from place to place?: Hours per day. Day
total amount of time you spent over the last 7 days - Walking Place Hours per
walking from place to place?: Hours per week. Week
time did you usually spend on one of those days walking - Walking Place Minutes
from place to place?: Minutes per day. per Day
total amount of time you spent over the last 7 days - Walking Place Minutes
walking from place to place?: Minutes per week. per Week
C141791 IPA02-Walking Work IPA02-Walking Work International Physical Activity Questionnaire (November IPAQ Long Last 7 Days
time did you usually spend on one of those days walking - Walking Work Hours per
as part of your work?: Hours per day. Day
total amount of time you spent walking over the last 7 - Walking Work Hours per
days as part of your work?: Hours per week. Week
time did you usually spend on one of those days walking - Walking Work Minutes
as part of your work?: Minutes per day. per Day
total amount of time you spent walking over the last 7 - Walking Work Minutes
days as part of your work?: Minutes per week. per Week
page 743 of 1925

IPAQ03TC (International Physical Activity Questionnaire (October 2002) Long Last 7 Days Self-
Administered Format Questionnaire Test Code)
C141667 IPAQ03TC
Code Value
C141726 IPA0301 IPA03-Currently Have Job International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
or Unpaid Work 2002) - Long Last 7 Days Self-Administered Format - Do Self-Administered Format
you currently have a job or do any unpaid work outside Version - Currently Have
your home? Job or Unpaid Work
C141727 IPA0302A IPA03-Days Vigorous as International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Part of Work 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you do Version - Days Vigorous
vigorous physical activities like heavy lifting, digging, as Part of Work
heavy construction, or climbing up stairs as part of your
work?: days per week.
C141728 IPA0302B IPA03-No Vigorous Job- International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
related Activity 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you do Version - No Vigorous
vigorous physical activities like heavy lifting, digging, Job-related Activity
work?: No vigorous job-related physical activity.
C141729 IPA0303A IPA03-Vigorous Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Hours per Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Vigorous Work
days doing vigorous physical activities as part of your Hours per Day
work?: hours per day.
C141730 IPA0303B IPA03-Vigorous Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Minutes per Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
days doing vigorous physical activities as part of your Minutes per Day
work?: minutes per day.
C141731 IPA0304A IPA03-Days Moderate as International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Part of Work 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you do Version - Days Moderate
moderate physical activities like carrying light loads as as Part of Work
part of your work?: days per week.
C141732 IPA0304B IPA03-No Moderate Job- International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
related Activity 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you do Version - No Moderate
moderate physical activities like carrying light loads as Job-related Activity
part of your work?: No moderate job-related physical
activity.
C141733 IPA0305A IPA03-Moderate Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
How much time did you usually spend on one of those Version - Moderate Work
days doing moderate physical activities as part of your Hours per Day
C141734 IPA0305B IPA03-Moderate Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities as part of your Minutes per Day
C141735 IPA0306A IPA03-Days Walk as Part International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
of Your Work 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you walk Version - Days Walk as
for at least 10 minutes at a time as part of your work?: Part of Your Work
days per week.
C141736 IPA0306B IPA03-No Job-related International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Walking 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you walk Version - No Job-related
for at least 10 minutes at a time as part of your work?: Walking
No job-related walking.
C141737 IPA0307A IPA03-Walking Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
How much time did you usually spend on one of those Version - Walking Work
days walking as part of your work?: hours per day. Hours per Day
C141738 IPA0307B IPA03-Walking Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking as part of your work?: minutes per day. Minutes per Day
page 744 of 1925

C141667 IPAQ03TC
Code Value
C141739 IPA0308A IPA03-Days Travel in a International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Motor Vehicle 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you travel Version - Days Travel in a
in a motor vehicle like a train, bus, car or tram?: days per Motor Vehicle
week.
C141740 IPA0308B IPA03-No Traveling in a International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Motor Vehicle 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you travel Version - No Traveling in
in a motor vehicle like a train, bus, car or tram?: No a Motor Vehicle
traveling in a motor vehicle.
C141741 IPA0309A IPA03-Traveling Hours International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
per Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Traveling Hours
days traveling in a train, bus, car, tram, or other kind of per Day
motor vehicle?: hours per day.
C141742 IPA0309B IPA03-Traveling Minutes International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
per Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Traveling
days traveling in a train, bus, car, tram, or other kind of Minutes per Day
motor vehicle?: minutes per day.
C141743 IPA0310A IPA03-Days Bicycle Place International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
to Place 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you bicycle Version - Days Bicycle
for at least 10 minutes at a time to go from place to Place to Place
place?: days per week.
C141744 IPA0310B IPA03-No Bicycling From International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Place to Place 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you bicycle Version - No Bicycling
for at least 10 minutes at a time to go from place to From Place to Place
place?: No bicycling from place to place.
C141745 IPA0311A IPA03-Bicycle Hours per International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Bicycle Hours
days to bicycle from place to place?: hours per day. per Day
C141746 IPA0311B IPA03-Bicycle Minutes per International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Bicycle Minutes
days to bicycle from place to place?: minutes per day. per Day
C141747 IPA0312A IPA03-Days Walk Place to International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Place 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you walk Version - Days Walk Place
for at least 10 minutes at a time to go from place to to Place
C141748 IPA0312B IPA03-No Walking From International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Place to Place 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you walk Version - No Walking
place?: No walking from place to place.
C141749 IPA0313A IPA03-Walking Place International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
How much time did you usually spend on one of those Version - Walking Place
days walking from place to place?: hours per day. Hours per Day
C141750 IPA0313B IPA03-Walking Place International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking from place to place?: minutes per day. Minutes per Day
C141751 IPA0314A IPA03-Days Vigorous in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
the Garden/Yard 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
vigorous physical activities like heavy lifting, chopping in the Garden/Yard
wood, shoveling snow, or digging in the garden or yard?:
days per week.
C141752 IPA0314B IPA03-No Vigorous International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Activity Garden/Yard 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
vigorous physical activities like heavy lifting, chopping Activity Garden/Yard
No vigorous activity in garden or yard.
page 745 of 1925

C141667 IPAQ03TC
Code Value
C141753 IPA0315A IPA03-Vigorous Garden International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
How much time did you usually spend on one of those Version - Vigorous
days doing vigorous physical activities in the garden or Garden Hours per Day
yard?: hours per day.
C141754 IPA0315B IPA03-Vigorous Garden International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities in the garden or Garden Minutes per Day
yard?: minutes per day.
C141755 IPA0316A IPA03-Days Moderate in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
the Garden/Yard 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate activities like carrying light loads, sweeping, in the Garden/Yard
washing windows, and raking in the garden or yard?:
days per week.
C141756 IPA0316B IPA03-No Moderate International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Activity Garden/Yard 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate activities like carrying light loads, sweeping, Activity Garden/Yard
washing windows, and raking in the garden or yard?: No
moderate activity in garden or yard.
C141757 IPA0317A IPA03-Moderate Garden International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
How much time did you usually spend on one of those Version - Moderate
days doing moderate physical activities in the garden or Garden Hours per Day
C141758 IPA0317B IPA03-Moderate Garden International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities in the garden or Garden Minutes per Day
C141759 IPA0318A IPA03-Days Moderate International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Inside Home 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate activities like carrying light loads, washing Inside Home
windows, scrubbing floors and sweeping inside your
home?: days per week.
Activity Inside Home 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate activities like carrying light loads, washing Activity Inside Home
home?: No moderate activity inside home.
C141761 IPA0319A IPA03-Moderate Home International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
How much time did you usually spend on one of those Version - Moderate Home
days doing moderate physical activities inside your Hours per Day
home?: hours per day.
C141762 IPA0319B IPA03-Moderate Home International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities inside your Minutes per Day
home?: minutes per day.
C141763 IPA0320A IPA03-Days Walk in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Leisure Time 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you walk Version - Days Walk in
for at least 10 minutes at a time in your leisure time?: Leisure Time
days per week.
C141764 IPA0320B IPA03-No Walking in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
During the last 7 days, on how many days did you walk Version - No Walking in
for at least 10 minutes at a time in your leisure time?: No Leisure Time
walking in leisure time.
C141765 IPA0321A IPA03-Walking Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
How much time did you usually spend on one of those Version - Walking Leisure
days walking in your leisure time?: hours per day. Hours per Day
C141766 IPA0321B IPA03-Walking Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking in your leisure time?: minutes per day. Minutes per Day
page 746 of 1925

C141667 IPAQ03TC
Code Value
C141767 IPA0322A IPA03-Days Vigorous in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
vigorous physical activities like aerobics, running, fast in Leisure Time
bicycling, or fast swimming in your leisure time?: days
per week.
C141768 IPA0322B IPA03-No Vigorous International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Activity Leisure Time 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
vigorous physical activities like aerobics, running, fast Activity Leisure Time
bicycling, or fast swimming in your leisure time?: No
vigorous activity in leisure time.
C141769 IPA0323A IPA03-Vigorous Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities in your leisure Leisure Hours per Day
time?: hours per day.
C141770 IPA0323B IPA03-Vigorous Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities in your leisure Leisure Minutes per Day
time?: minutes per day.
C141771 IPA0324A IPA03-Days Moderate in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
moderate physical activities like bicycling at a regular in Leisure Time
pace, swimming at a regular pace, and doubles tennis in
your leisure time?: days per week.
Activity Leisure Time 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate physical activities like bicycling at a regular Activity Leisure Time
your leisure time?: No moderate activity in leisure time.
C141773 IPA0325A IPA03-Moderate Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities in your leisure Leisure Hours per Day
C141774 IPA0325B IPA03-Moderate Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities in your leisure Leisure Minutes per Day
C141775 IPA0326A IPA03-Sitting Weekday International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
During the last 7 days, how much time did you usually Version - Sitting Weekday
spend sitting on a weekday?: hours per day. Hours per Day
C141776 IPA0326B IPA03-Sitting Weekday International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
spend sitting on a weekday?: minutes per day. Minutes per Day
C141777 IPA0327A IPA03-Sitting Weekend International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
During the last 7 days, how much time did you usually Version - Sitting Weekend
spend sitting on a weekend day?: hours per day. Hours per Day
C141778 IPA0327B IPA03-Sitting Weekend International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
spend sitting on a weekend day?: minutes per day. Minutes per Day
page 747 of 1925

IPAQ03TN (International Physical Activity Questionnaire (October 2002) Long Last 7 Days Self-
Administered Format Questionnaire Test Name)
C141666 IPAQ03TN
Code Value
C141745 IPA03-Bicycle Hours per IPA03-Bicycle Hours per International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Day Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Bicycle Hours
days to bicycle from place to place?: hours per day. per Day
C141746 IPA03-Bicycle Minutes per IPA03-Bicycle Minutes per International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Day Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Bicycle Minutes
days to bicycle from place to place?: minutes per day. per Day
C141726 IPA03-Currently Have Job IPA03-Currently Have Job International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
or Unpaid Work or Unpaid Work 2002) - Long Last 7 Days Self-Administered Format - Do Self-Administered Format
you currently have a job or do any unpaid work outside Version - Currently Have
your home? Job or Unpaid Work
C141743 IPA03-Days Bicycle Place IPA03-Days Bicycle Place International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
to Place to Place 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you bicycle Version - Days Bicycle
for at least 10 minutes at a time to go from place to Place to Place
C141731 IPA03-Days Moderate as IPA03-Days Moderate as International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Part of Work Part of Work 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate physical activities like carrying light loads as as Part of Work
part of your work?: days per week.
C141771 IPA03-Days Moderate in IPA03-Days Moderate in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Leisure Time Leisure Time 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate physical activities like bicycling at a regular in Leisure Time
your leisure time?: days per week.
C141755 IPA03-Days Moderate in IPA03-Days Moderate in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
the Garden/Yard the Garden/Yard 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate activities like carrying light loads, sweeping, in the Garden/Yard
washing windows, and raking in the garden or yard?:
days per week.
C141759 IPA03-Days Moderate IPA03-Days Moderate International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Inside Home Inside Home 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate activities like carrying light loads, washing Inside Home
home?: days per week.
C141739 IPA03-Days Travel in a IPA03-Days Travel in a International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Motor Vehicle Motor Vehicle 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you travel Version - Days Travel in a
in a motor vehicle like a train, bus, car or tram?: days per Motor Vehicle
week.
C141727 IPA03-Days Vigorous as IPA03-Days Vigorous as International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Part of Work Part of Work 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
vigorous physical activities like heavy lifting, digging, as Part of Work
work?: days per week.
C141767 IPA03-Days Vigorous in IPA03-Days Vigorous in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
vigorous physical activities like aerobics, running, fast in Leisure Time
bicycling, or fast swimming in your leisure time?: days
per week.
C141751 IPA03-Days Vigorous in IPA03-Days Vigorous in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
the Garden/Yard the Garden/Yard 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
vigorous physical activities like heavy lifting, chopping in the Garden/Yard
days per week.
page 748 of 1925

C141666 IPAQ03TN
Code Value
C141735 IPA03-Days Walk as Part IPA03-Days Walk as Part International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
of Your Work of Your Work 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you walk Version - Days Walk as
for at least 10 minutes at a time as part of your work?: Part of Your Work
days per week.
C141763 IPA03-Days Walk in IPA03-Days Walk in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
During the last 7 days, on how many days did you walk Version - Days Walk in
for at least 10 minutes at a time in your leisure time?: Leisure Time
days per week.
C141747 IPA03-Days Walk Place to IPA03-Days Walk Place to International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Place Place 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you walk Version - Days Walk Place
for at least 10 minutes at a time to go from place to to Place
C141757 IPA03-Moderate Garden IPA03-Moderate Garden International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Hours per Day Hours per Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
days doing moderate physical activities in the garden or Garden Hours per Day
C141758 IPA03-Moderate Garden IPA03-Moderate Garden International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Minutes per Day Minutes per Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
days doing moderate physical activities in the garden or Garden Minutes per Day
C141761 IPA03-Moderate Home IPA03-Moderate Home International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities inside your Hours per Day
home?: hours per day.
C141762 IPA03-Moderate Home IPA03-Moderate Home International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities inside your Minutes per Day
home?: minutes per day.
C141773 IPA03-Moderate Leisure IPA03-Moderate Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities in your leisure Leisure Hours per Day
C141774 IPA03-Moderate Leisure IPA03-Moderate Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities in your leisure Leisure Minutes per Day
C141733 IPA03-Moderate Work IPA03-Moderate Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities as part of your Hours per Day
C141734 IPA03-Moderate Work IPA03-Moderate Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing moderate physical activities as part of your Minutes per Day
C141744 IPA03-No Bicycling From IPA03-No Bicycling From International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Place to Place Place to Place 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you bicycle Version - No Bicycling
place?: No bicycling from place to place.
C141736 IPA03-No Job-related IPA03-No Job-related International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Walking Walking 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you walk Version - No Job-related
for at least 10 minutes at a time as part of your work?: Walking
No job-related walking.
C141756 IPA03-No Moderate IPA03-No Moderate International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Activity Garden/Yard Activity Garden/Yard 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate activities like carrying light loads, sweeping, Activity Garden/Yard
washing windows, and raking in the garden or yard?: No
moderate activity in garden or yard.
page 749 of 1925

C141666 IPAQ03TN
Code Value
Activity Inside Home Activity Inside Home 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate activities like carrying light loads, washing Activity Inside Home
home?: No moderate activity inside home.
Activity Leisure Time Activity Leisure Time 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate physical activities like bicycling at a regular Activity Leisure Time
your leisure time?: No moderate activity in leisure time.
C141732 IPA03-No Moderate Job- IPA03-No Moderate Job- International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
related Activity related Activity 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
moderate physical activities like carrying light loads as Job-related Activity
part of your work?: No moderate job-related physical
activity.
C141740 IPA03-No Traveling in a IPA03-No Traveling in a International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Motor Vehicle Motor Vehicle 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
During the last 7 days, on how many days did you travel Version - No Traveling in
in a motor vehicle like a train, bus, car or tram?: No a Motor Vehicle
traveling in a motor vehicle.
C141752 IPA03-No Vigorous IPA03-No Vigorous International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Activity Garden/Yard Activity Garden/Yard 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
vigorous physical activities like heavy lifting, chopping Activity Garden/Yard
No vigorous activity in garden or yard.
C141768 IPA03-No Vigorous IPA03-No Vigorous International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Activity Leisure Time Activity Leisure Time 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
vigorous physical activities like aerobics, running, fast Activity Leisure Time
bicycling, or fast swimming in your leisure time?: No
vigorous activity in leisure time.
C141728 IPA03-No Vigorous Job- IPA03-No Vigorous Job- International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
related Activity related Activity 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
vigorous physical activities like heavy lifting, digging, Job-related Activity
work?: No vigorous job-related physical activity.
C141748 IPA03-No Walking From IPA03-No Walking From International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
Place to Place Place to Place 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
place?: No walking from place to place.
C141764 IPA03-No Walking in IPA03-No Walking in International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
During the last 7 days, on how many days did you walk Version - No Walking in
for at least 10 minutes at a time in your leisure time?: No Leisure Time
walking in leisure time.
C141775 IPA03-Sitting Weekday IPA03-Sitting Weekday International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
spend sitting on a weekday?: hours per day. Hours per Day
C141776 IPA03-Sitting Weekday IPA03-Sitting Weekday International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
spend sitting on a weekday?: minutes per day. Minutes per Day
C141777 IPA03-Sitting Weekend IPA03-Sitting Weekend International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
spend sitting on a weekend day?: hours per day. Hours per Day
C141778 IPA03-Sitting Weekend IPA03-Sitting Weekend International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
spend sitting on a weekend day?: minutes per day. Minutes per Day
C141741 IPA03-Traveling Hours IPA03-Traveling Hours International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
per Day per Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Traveling Hours
days traveling in a train, bus, car, tram, or other kind of per Day
motor vehicle?: hours per day.
page 750 of 1925

C141666 IPAQ03TN
Code Value
C141742 IPA03-Traveling Minutes IPA03-Traveling Minutes International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
per Day per Day 2002) - Long Last 7 Days Self-Administered Format - Self-Administered Format
How much time did you usually spend on one of those Version - Traveling
days traveling in a train, bus, car, tram, or other kind of Minutes per Day
motor vehicle?: minutes per day.
C141753 IPA03-Vigorous Garden IPA03-Vigorous Garden International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities in the garden or Garden Hours per Day
C141754 IPA03-Vigorous Garden IPA03-Vigorous Garden International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities in the garden or Garden Minutes per Day
C141769 IPA03-Vigorous Leisure IPA03-Vigorous Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities in your leisure Leisure Hours per Day
C141770 IPA03-Vigorous Leisure IPA03-Vigorous Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities in your leisure Leisure Minutes per Day
C141729 IPA03-Vigorous Work IPA03-Vigorous Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities as part of your Hours per Day
C141730 IPA03-Vigorous Work IPA03-Vigorous Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days doing vigorous physical activities as part of your Minutes per Day
C141765 IPA03-Walking Leisure IPA03-Walking Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking in your leisure time?: hours per day. Hours per Day
C141766 IPA03-Walking Leisure IPA03-Walking Leisure International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking in your leisure time?: minutes per day. Minutes per Day
C141749 IPA03-Walking Place IPA03-Walking Place International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking from place to place?: hours per day. Hours per Day
C141750 IPA03-Walking Place IPA03-Walking Place International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking from place to place?: minutes per day. Minutes per Day
C141737 IPA03-Walking Work IPA03-Walking Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking as part of your work?: hours per day. Hours per Day
C141738 IPA03-Walking Work IPA03-Walking Work International Physical Activity Questionnaire (October IPAQ Long Last 7 Days
days walking as part of your work?: minutes per day. Minutes per Day
page 751 of 1925

IPAQ04TC (International Physical Activity Questionnaire (August 2002) Short Last 7 Days Self-
Administered Format Questionnaire Test Code)
C141665 IPAQ04TC
Code Value
C141708 IPA0401A IPA04-Days Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Physical Activities 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
vigorous physical activities like heavy lifting, digging, Physical Activities
aerobics, or fast bicycling?: days per week.
C141709 IPA0401B IPA04-No Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
aerobics, or fast bicycling?: No vigorous physical
activities.
C141710 IPA0402A IPA04-Vigorous Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Hours per Day 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
How much time did you usually spend doing vigorous Version - Vigorous
physical activities on one of those days?: hours per day. Physical Hours per Day
C141711 IPA0402B IPA04-Vigorous Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Minutes per Day 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
physical activities on one of those days?: minutes per Physical Minutes per Day
day.
C141712 IPA0402C IPA04-Time Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Don't Know/Not Sure 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
How much time did you usually spend doing vigorous Version - Time Vigorous
physical activities on one of those days?: Don't know/Not Don't Know/Not Sure
sure.
C141713 IPA0403A IPA04-Days Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
moderate physical activities like carrying light loads, Physical Activities
bicycling at a regular pace, or doubles tennis?: days per
week.
C141714 IPA0403B IPA04-No Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
bicycling at a regular pace, or doubles tennis?: No
moderate physical activities.
C141715 IPA0404A IPA04-Moderate Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
How much time did you usually spend doing moderate Version - Moderate
C141716 IPA0404B IPA04-Moderate Physical International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
day.
C141717 IPA0404C IPA04-Time Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
How much time did you usually spend doing moderate Version - Time Moderate
sure.
C141718 IPA0405A IPA04-Days Walk at Least International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
10 Minutes 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
During the last 7 days, on how many days did you walk Version - Days Walk at
for at least 10 minutes at a time?: days per week. Least 10 Minutes
C141719 IPA0405B IPA04-No Walking International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
for at least 10 minutes at a time?: No walking.
C141720 IPA0406A IPA04-Walking Hours per International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Day 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
How much time did you usually spend walking on one of Version - Walking Hours
those days?: hours per day. per Day
page 752 of 1925

C141665 IPAQ04TC
Code Value
C141721 IPA0406B IPA04-Walking Minutes International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
per Day 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
How much time did you usually spend walking on one of Version - Walking Minutes
those days?: minutes per day. per Day
C141722 IPA0406C IPA04-Time Walking International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
How much time did you usually spend walking on one of Version - Time Walking
those days?: Don't know/Not sure. Don't Know/Not Sure
C141723 IPA0407A IPA04-Sitting Weekday International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
During the last 7 days, how much time did you spend Version - Sitting Weekday
sitting on a weekday?: hours per day. Hours per Day
C141724 IPA0407B IPA04-Sitting Weekday International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
sitting on a weekday?: minutes per day. Minutes per Day
C141725 IPA0407C IPA04-Time Sitting Don't International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Know/Not Sure 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
During the last 7 days, how much time did you spend Version - Time Sitting
sitting on a weekday?: Don't know/Not sure. Don't Know/Not Sure
page 753 of 1925

IPAQ04TN (International Physical Activity Questionnaire (August 2002) Short Last 7 Days Self-
Administered Format Questionnaire Test Name)
C141664 IPAQ04TN
Code Value
C141713 IPA04-Days Moderate IPA04-Days Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Physical Activities Physical Activities 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
bicycling at a regular pace, or doubles tennis?: days per
week.
C141708 IPA04-Days Vigorous IPA04-Days Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
aerobics, or fast bicycling?: days per week.
C141718 IPA04-Days Walk at Least IPA04-Days Walk at Least International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
10 Minutes 10 Minutes 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
During the last 7 days, on how many days did you walk Version - Days Walk at
for at least 10 minutes at a time?: days per week. Least 10 Minutes
Hours per Day Hours per Day 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
Minutes per Day Minutes per Day 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
day.
C141714 IPA04-No Moderate IPA04-No Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
bicycling at a regular pace, or doubles tennis?: No
moderate physical activities.
C141709 IPA04-No Vigorous IPA04-No Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
aerobics, or fast bicycling?: No vigorous physical
activities.
C141719 IPA04-No Walking IPA04-No Walking International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
for at least 10 minutes at a time?: No walking.
C141723 IPA04-Sitting Weekday IPA04-Sitting Weekday International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
sitting on a weekday?: hours per day. Hours per Day
C141724 IPA04-Sitting Weekday IPA04-Sitting Weekday International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
sitting on a weekday?: minutes per day. Minutes per Day
C141717 IPA04-Time Moderate IPA04-Time Moderate International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Don't Know/Not Sure Don't Know/Not Sure 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
How much time did you usually spend doing moderate Version - Time Moderate
sure.
C141725 IPA04-Time Sitting Don't IPA04-Time Sitting Don't International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Know/Not Sure Know/Not Sure 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
During the last 7 days, how much time did you spend Version - Time Sitting
sitting on a weekday?: Don't know/Not sure. Don't Know/Not Sure
C141712 IPA04-Time Vigorous IPA04-Time Vigorous International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
How much time did you usually spend doing vigorous Version - Time Vigorous
sure.
C141722 IPA04-Time Walking IPA04-Time Walking International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
How much time did you usually spend walking on one of Version - Time Walking
those days?: Don't know/Not sure. Don't Know/Not Sure
page 754 of 1925

C141664 IPAQ04TN
Code Value
day.
C141720 IPA04-Walking Hours per IPA04-Walking Hours per International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
Day Day 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
How much time did you usually spend walking on one of Version - Walking Hours
those days?: hours per day. per Day
C141721 IPA04-Walking Minutes IPA04-Walking Minutes International Physical Activity Questionnaire (August IPAQ Short Last 7 Days
per Day per Day 2002) - Short Last 7 Days Self-Administered Format - Self-administered Format
How much time did you usually spend walking on one of Version - Walking Minutes
those days?: minutes per day. per Day
page 755 of 1925

ISTEST (Immunogenicity Specimen Assessments Test Name)
C120526 ISTEST
Code Value
C147272 Binding Antidrug Antibody Binding Antidrug Antibody A measurement of the binding antidrug antibody in a Binding Antidrug Antibody
biological specimen. Measurement
C147275 Cross-Reactive Binding Cross-Reactive Binding A measurement of the cross-reactive binding antidrug Cross-Reactive Binding
Antidrug Antibody Antidrug Antibody antibody in a biological specimen. Antidrug Antibody
Measurement
C132360 EBOV Specific IgG AB EBOV Specific IgG AB A measurement of the Ebola virus specific IgG antibody Ebola Virus Specific IgG
Secreting Cells Secreting Cells secreting cells in a biological specimen. Antibody Secreting Cell
Count
C132361 EBOV Specific IgM AB EBOV Specific IgM AB A measurement of the Ebola virus specific IgM antibody Ebola Virus Specific IgM
Secreting Cells Secreting Cells secreting cells in a biological specimen. Antibody Secreting Cell
Count
C120622 H1 Specific IgG Antibody H1 Specific IgG ASCs;H1 A measurement of the H1 specific IgG antibody secreting Influenza Hemagglutinin
Secreting Cells Specific IgG Antibody cells in a biological specimen. 1 Specific IgG Antibody
Secreting Cells Secreting Cell Count
C120623 H3 Specific IgG Antibody H3 Specific IgG ASCs;H3 A measurement of the H3 specific IgG antibody secreting Influenza Hemagglutinin
Secreting Cells Specific IgG Antibody cells in a biological specimen. 3 Specific IgG Antibody
C132362 IgM Antibody Secreting IgM Antibody Secreting A measurement of the total IgM antibody secreting cells IgM Antibody Secreting
Cells Cells in a biological specimen. Cell Count
C147274 Neutraliz Cross-React Neutraliz Cross-React A measurement of the neutralizing cross-reactive binding Neutralizing Cross-
Bind Antidrug AB Bind Antidrug antidrug antibody in a biological specimen. Reacting Binding Antidrug
AB;Neutralizing Cross- Antibody Measurement
Reactive Binding Antidrug
Antibody
C147273 Neutralizing Binding Neutralizing Binding A measurement of the neutralizing binding antidrug Neutralizing Binding
Antidrug Antibody Antidrug Antibody antibody in a biological specimen. Antidrug Antibody
Measurement
C120624 Total IgG Antibody Total IgG ASCs;Total IgG A measurement of the total IgG antibody secreting cells Total IgG Antibody
Secreting Cells Antibody Secreting Cells in a biological specimen. Secreting Cell Count
page 756 of 1925

ISTESTCD (Immunogenicity Specimen Assessments Test Code)
C120525 ISTESTCD
Code Value
C147272 ADA_BAB Binding Antidrug Antibody A measurement of the binding antidrug antibody in a Binding Antidrug Antibody
C147273 ADA_NAB Neutralizing Binding A measurement of the neutralizing binding antidrug Neutralizing Binding
Antidrug Antibody antibody in a biological specimen. Antidrug Antibody
Measurement
C147274 ADA_NX Neutraliz Cross-React A measurement of the neutralizing cross-reactive binding Neutralizing Cross-
Bind Antidrug antidrug antibody in a biological specimen. Reacting Binding Antidrug
AB;Neutralizing Cross- Antibody Measurement
Reactive Binding Antidrug
Antibody
C147275 ADA_X Cross-Reactive Binding A measurement of the cross-reactive binding antidrug Cross-Reactive Binding
Antidrug Antibody antibody in a biological specimen. Antidrug Antibody
Measurement
C132360 EVIGGASC EBOV Specific IgG AB A measurement of the Ebola virus specific IgG antibody Ebola Virus Specific IgG
Secreting Cells secreting cells in a biological specimen. Antibody Secreting Cell
Count
C132361 EVIGMASC EBOV Specific IgM AB A measurement of the Ebola virus specific IgM antibody Ebola Virus Specific IgM
Secreting Cells secreting cells in a biological specimen. Antibody Secreting Cell
Count
C120622 H1IGGASC H1 Specific IgG ASCs;H1 A measurement of the H1 specific IgG antibody secreting Influenza Hemagglutinin
Specific IgG Antibody cells in a biological specimen. 1 Specific IgG Antibody
C120623 H3IGGASC H3 Specific IgG ASCs;H3 A measurement of the H3 specific IgG antibody secreting Influenza Hemagglutinin
Specific IgG Antibody cells in a biological specimen. 3 Specific IgG Antibody
C132362 IGMABSC IgM Antibody Secreting A measurement of the total IgM antibody secreting cells IgM Antibody Secreting
Cells in a biological specimen. Cell Count
C120624 TIGGASC Total IgG ASCs;Total IgG A measurement of the total IgG antibody secreting cells Total IgG Antibody
Antibody Secreting Cells in a biological specimen. Secreting Cell Count
page 757 of 1925

IVIS01TC (Impact of Visual Impairment Scale Questionnaire Test Code)
C113856 IVIS01TC
Code Value
C113962 IVIS0101 IVIS01-Read or Access Impact of Visual Impairment Scale - During the past 4 IVIS - Read or Access
Personal Letters weeks, how difficult did you find it to read or access Personal Letters
personal letters or notes?
Printed Materials weeks, how difficult did you find it to read or access Printed Materials
printed materials, such as books, magazines, newspaper,
etc.?
Dials weeks, how difficult did you find it to read or access dials, Dials
such as on stoves, thermostats, etc.?
C113965 IVIS0104 IVIS01-Watch TV/ID Impact of Visual Impairment Scale - During the past 4 IVIS - Watch TV or
Faces From Distance weeks, how difficult did you find it to watch television or Identify Faces From
identify faces from a distance? Distance
C113966 IVIS0105 IVIS01-Identify House Impact of Visual Impairment Scale - During the past 4 IVIS - Identify House
Number/Street Sign weeks, how difficult did you find it to identify house Numbers or Street Signs
numbers, street signs, etc.?
page 758 of 1925

IVIS01TN (Impact of Visual Impairment Scale Questionnaire Test Name)
C113855 IVIS01TN
Code Value
C113966 IVIS01-Identify House IVIS01-Identify House Impact of Visual Impairment Scale - During the past 4 IVIS - Identify House
Number/Street Sign Number/Street Sign weeks, how difficult did you find it to identify house Numbers or Street Signs
numbers, street signs, etc.?
C113964 IVIS01-Read or Access IVIS01-Read or Access Impact of Visual Impairment Scale - During the past 4 IVIS - Read or Access
Dials Dials weeks, how difficult did you find it to read or access dials, Dials
such as on stoves, thermostats, etc.?
Personal Letters Personal Letters weeks, how difficult did you find it to read or access Personal Letters
personal letters or notes?
Printed Materials Printed Materials weeks, how difficult did you find it to read or access Printed Materials
printed materials, such as books, magazines, newspaper,
etc.?
C113965 IVIS01-Watch TV/ID IVIS01-Watch TV/ID Impact of Visual Impairment Scale - During the past 4 IVIS - Watch TV or
Faces From Distance Faces From Distance weeks, how difficult did you find it to watch television or Identify Faces From
identify faces from a distance? Distance
page 759 of 1925

KDPI01TC (Kidney Donor Profile Index Clinical Classification Test Code)
C130251 KDPI01TC
Code Value
C130393 KDPI0101 KDPI01-KDPI Score Kidney Donor Profile Index - KDPI score. KDPI - KDPI Score
page 760 of 1925

KDPI01TN (Kidney Donor Profile Index Clinical Classification Test Name)
C130250 KDPI01TN
Code Value
C130393 KDPI01-KDPI Score KDPI01-KDPI Score Kidney Donor Profile Index - KDPI score. KDPI - KDPI Score
page 761 of 1925

KFSS1TC (Kurtzke Functional Systems Scores Questionnaire Test Code)
C112443 KFSS1TC
Code Value
C112609 KFSS101 KFSS1-Pyramidal Kurtzke Functional Systems Scores - Pyramidal functions. KFSS - Pyramidal
Functions Functions
C112610 KFSS102 KFSS1-Cerebellar Kurtzke Functional Systems Scores - Cerebellar functions. KFSS - Cerebellar
Functions Functions
C112611 KFSS102A KFSS1-Weakness Kurtzke Functional Systems Scores - Check here when KFSS - Weakness
Interferes With Testing weakness (grade 3 or more on pyramidal) interferes with Interferes With Testing
testing.
C112612 KFSS103 KFSS1-Brain Stem Kurtzke Functional Systems Scores - Brain stem KFSS - Brain Stem
Functions functions. Functions
C112613 KFSS104 KFSS1-Sensory Functions Kurtzke Functional Systems Scores - Sensory functions. KFSS - Sensory Functions
C112614 KFSS105 KFSS1-Bowel and Bladder Kurtzke Functional Systems Scores - Bowel and bladder KFSS - Bowel and Bladder
C112615 KFSS106 KFSS1-Visual or Optic Kurtzke Functional Systems Scores - Visual (or optic) KFSS - Visual (or Optic)
C112616 KFSS106A KFSS1-Presence of Kurtzke Functional Systems Scores - Check here for KFSS - Presence of
Temporal Pallor presence of temporal pallor. Temporal Pallor
C112617 KFSS107 KFSS1-Cerebral or Mental Kurtzke Functional Systems Scores - Cerebral (or mental) KFSS - Cerebral (or
Functions functions. Mental) Functions
C113884 KFSS108 KFSS1-Other Functions Kurtzke Functional Systems Scores - Other functions. KFSS - Other Functions
C113885 KFSS108A KFSS1-Other Functions Kurtzke Functional Systems Scores - Any other neurologic KFSS - Other Functions
Specify findings attributed to MS (specify). Specify
page 762 of 1925

KFSS1TN (Kurtzke Functional Systems Scores Questionnaire Test Name)
C112442 KFSS1TN
Code Value
C112614 KFSS1-Bowel and Bladder KFSS1-Bowel and Bladder Kurtzke Functional Systems Scores - Bowel and bladder KFSS - Bowel and Bladder
Functions Functions functions. Functions
C112612 KFSS1-Brain Stem KFSS1-Brain Stem Kurtzke Functional Systems Scores - Brain stem KFSS - Brain Stem
C112610 KFSS1-Cerebellar KFSS1-Cerebellar Kurtzke Functional Systems Scores - Cerebellar functions. KFSS - Cerebellar
Functions Functions Functions
C112617 KFSS1-Cerebral or Mental KFSS1-Cerebral or Mental Kurtzke Functional Systems Scores - Cerebral (or mental) KFSS - Cerebral (or
Functions Functions functions. Mental) Functions
C113884 KFSS1-Other Functions KFSS1-Other Functions Kurtzke Functional Systems Scores - Other functions. KFSS - Other Functions
C113885 KFSS1-Other Functions KFSS1-Other Functions Kurtzke Functional Systems Scores - Any other neurologic KFSS - Other Functions
Specify Specify findings attributed to MS (specify). Specify
C112616 KFSS1-Presence of KFSS1-Presence of Kurtzke Functional Systems Scores - Check here for KFSS - Presence of
Temporal Pallor Temporal Pallor presence of temporal pallor. Temporal Pallor
C112609 KFSS1-Pyramidal KFSS1-Pyramidal Kurtzke Functional Systems Scores - Pyramidal functions. KFSS - Pyramidal
Functions Functions Functions
C112613 KFSS1-Sensory Functions KFSS1-Sensory Functions Kurtzke Functional Systems Scores - Sensory functions. KFSS - Sensory Functions
C112615 KFSS1-Visual or Optic KFSS1-Visual or Optic Kurtzke Functional Systems Scores - Visual (or optic) KFSS - Visual (or Optic)
C112611 KFSS1-Weakness KFSS1-Weakness Kurtzke Functional Systems Scores - Check here when KFSS - Weakness
Interferes With Testing Interferes With Testing weakness (grade 3 or more on pyramidal) interferes with Interferes With Testing
testing.
page 763 of 1925

KILLIPC (Killip Class Responses)
C101840 KILLIPC
Code Value
C77269 KILLIP CLASS I The absence of rales over the lung fields and absence of Killip Class I
third heart sound (S3). (ACC/AHA)
C77270 KILLIP CLASS II The presence of rales over 50% or less of the lung fields Killip Class II
or the presence of a third heart sound (S3).(ACC/AHA)
C77271 KILLIP CLASS III The presence of rales over more than 50% of the lung Killip Class III
fields. (ACC/AHA)
C77272 KILLIP CLASS IV The presence of cardiogenic shock (systolic BP less than Killip Class IV
90 mm Hg) for greater than 30 minutes, not responsive
to fluid resuscitation alone, and felt to be secondary to
cardiac dysfunction. (ACC/AHA)
page 764 of 1925

KPSSTC (Karnofsky Performance Status Scale Questionnaire Test Code)
C100170 KPSSTC
Code Value
C100417 KPSS01 KPSS-Karnofsky Karnofsky Performance Status Scale - Karnofsky KPS Scale - Karnofsky
Performance Status Performance Status. Performance Status
page 765 of 1925

KPSSTN (Karnofsky Performance Status Scale Questionnaire Test Name)
C100169 KPSSTN
Code Value
C100417 KPSS-Karnofsky KPSS-Karnofsky Karnofsky Performance Status Scale - Karnofsky KPS Scale - Karnofsky
Performance Status Performance Status Performance Status. Performance Status
page 766 of 1925

LAT (Laterality)
C99073 LAT
Code Value
C13332 BILATERAL Affecting both sides of the body, or a pair of organs. Bilateral
C25307 CONTRALATERAL Having to do with the opposite side of the body, in Contralateral
relation to a pre-existing reference point.
C25308 IPSILATERAL Having to do with the same side of the body, in relation Ipsilateral
to a pre-existing reference point.
C25230 LATERAL Situated at or extending to the side. Lateral
C25229 LEFT Being or located on or directed toward the side of the Left
body to the west when facing north.
C25228 RIGHT Being or located on or directed toward the side of the Right
body to the east when facing north.
C28012 UNILATERAL Affecting one side of the body or one of a pair of organs. Unilateral
page 767 of 1925

LBSTRESC (Laboratory Test Standard Character Result)
C102580 LBSTRESC
Code Value
C14157 BORDERLINE Straddling the dividing line between two categories. Borderline
C48658 INDETERMINATE Inconclusive Cannot distinguish between two or more possible values Indeterminate
in the current context. (NCI)
C50913 INVALID INV Not valid data. Invalid Data
C38757 NEGATIVE A finding of normality following an examination or Negative Finding

investigation looking for the presence of a microorganism,
disease, or condition.
C38758 POSITIVE An observation confirming something, such as the Positive Finding

presence of a disease, condition, or microorganism.
page 768 of 1925

LBTEST (Laboratory Test Name)
C6715 LBTEST
4
Code Value
C92267 1, 25-Dihydroxyvitamin D 1, 25-Dihydroxyvitamin D;Active Vitamin D A measurement of the total active 1, 25-Dihydroxyvitamin D
Vitamin D in a biological specimen. Measurement
C13237 1,3-Beta-D-Glucan 1,3-Beta-D-Glucan A measurement of the 1,3-beta-D- 1,3-Beta-D-Glucan

0 glucan in a biological specimen. Measurement
C12433 1,5-Anhydroglucitol 1,5-Anhydroglucitol A measurement of the 1,5- 1,5-Anhydroglucitol

4 anhydroglucitol in a biological Measurement
specimen.
C15473 1-Hydroxymidazolam 1'-Hydroxymidazolam;1- A measurement of the 1- 1-Hydroxymidazolam

2 Hydroxymidazolam;Alpha-Hydroxymidazolam Hydroxymidazolam present in a Measurement
biological specimen.
C10334 11-Dehydro-Thromboxane 11-Dehydro-Thromboxane B2 A measurement of the 11- 11-Dehydro-Thromboxane

4 B2 dehydro-thromboxane B2 in a B2 Measurement
C14229 11-Nor-Delta9-THC-9- 11-Nor-Delta9-THC-9-Carboxylic Acid;THC-COOH A measurement of 11-nor-delta-9- 11-Nor-Delta9-THC-9-

3 Carboxylic Acid tetrahydrocannabinol-9-carboxylic Carboxylic Acid
acid present in a biological Measurement
specimen.
C14737 17-Hydroxyprogesterone 17-Hydroxyprogesterone;17-OHP A measurement of the 17- 17-Hydroxyprogesterone

0 Hydroxyprogesterone in a Measurement
C14744 25-Hydroxyvit D2 + 25- 25-Hydroxyvit D2 + 25-Hydroxyvit D3 A measurement of the total 25-Hydroxyvitamin D2 and
6 Hydroxyvit D3 inactive vitamin D2 and vitamin 25-Hydroxyvitamin D3
D3 in a biological specimen. Measurement
C92268 25-Hydroxyvitamin D 25-Hydroxyvitamin D;Calcidiol;Inactive Vitamin A measurement of the total 25-Hydroxyvitamin D

D inactive Vitamin D in a biological Measurement
specimen.
C10334 3,4-Dihydroxyphenylacetic 3,4-Dihydroxyphenylacetic Acid A measurement of the 3,4- 3,4-Dihydroxyphenylacetic

5 Acid dihydroxyphenylacetic acid in a Acid Measurement
C10101 3,4-Dihydroxyphenylglycol 3,4-Dihydroxyphenylglycol;3.4 A measurement of the 3,4-Dihydroxyphenylglycol

7 Dihydroxyphenylglycol catecholamine metabolite, 3,4- Measurement
Dihydroxyphenylglycol in a
C75359 3,4- 3,4-methylenedioxymethamphetamine;Ecstasy A measurement of the 3,4- 3,4-

methylenedioxymethamph methylenedioxymethamphetamine Methylenedioxymethamph
etamine (MDMA) in a biological specimen. etamine Measurement
C15473 4-Hydroxymidazolam 4-Hydroxymidazolam A measurement of the 4- 4-Hydroxymidazolam

1 hydroxymidazolam present in a Measurement
C79437 5 Prime Nucleotidase 5 Prime Nucleotidase;5'-Ribonucleotide A measurement of the 5'- 5 Prime Nucleotidase
Phosphohydrolase nucleotidase in a biological Measurement
specimen.
C11221 5-Hydroxyindoleacetic Acid 5-Hydroxyindoleacetate;5-Hydroxyindoleacetic A measurement of 5- 5-Hydroxyindoleacetic Acid

7 Acid hydroxyindoleacetic acid in a Measurement
C15083 6 Beta-Hydroxycortisol 6 Beta-Hydrocortisol;6 Beta-Hydroxycortisol;6 A measurement of 6 beta- 6 Beta-Hydroxycortisol

3 beta-OHF hydroxycortisol in a biological Measurement
specimen.
C74876 6-Monoacetylmorphine 6-Monoacetylmorphine A measurement of the 6- 6-Monoacetylmorphine

monoacetylmorphine present in a Measurement
C11929 8-Iso- 8-Iso-PGF2alpha/Creatinine A relative measurement (ratio or 8-Iso-Prostaglandin F2

1 PGF2alpha/Creatinine percentage) of the prostaglandin Alpha to Creatinine Ratio
F2 alpha isoform 8 to creatinine in Measurement
a biological specimen.
C11929 8-Iso-Prostaglandin F2 8-Iso-Prostaglandin F2 Alpha A measurement of the 8-Iso-Prostaglandin F2

2 Alpha prostaglandin F2 alpha isoform 8 Alpha Measurement
in a biological specimen.
page 769 of 1925

C6715 LBTEST
4
Code Value
C96565 A Fetoprotein L3/A A Fetoprotein L3/A Fetoprotein A relative measurement (ratio or Alpha Fetoprotein L3 to
Fetoprotein percentage) of alpha fetoprotein Total Alpha Fetoprotein
L3 to total alpha fetoprotein in a Ratio Measurement
C11112 A Proliferation-Inducing A Proliferation-Inducing A measurement of the a A Proliferation-Inducing

3 Ligand Ligand;CD256;TNFSF13;Tumor Necrosis Factor proliferation-inducing ligand in a Ligand Measurement
Ligand Superfamily Member 13 biological specimen.
C13014 A. fumigatus Antigen IgE A. fumigatus Antigen IgE Antibody A measurement of the Aspergillus Aspergillus fumigatus
4 Antibody fumigatus antigen IgE antibody in Antigen IgE Antibody
a biological specimen. Measurement
C13014 A. fumigatus Antigen IgG A. fumigatus Antigen IgG Antibody A measurement of the Aspergillus Aspergillus fumigatus
5 Antibody fumigatus antigen IgG antibody in Antigen IgG Antibody
C13015 A. tenuis alternata Antigen A. tenuis alternata Antigen IgA AB A measurement of the Alternaria Alternaria tenuis alternata
1 IgA AB tenuis alternata antigen IgA Antigen IgA Antibody
antibody in a biological specimen. Measurement
C13015 A. tenuis alternata Antigen A. tenuis alternata Antigen IgE AB A measurement of the Alternaria Alternaria tenuis alternata
0 IgE AB tenuis alternata antigen IgE Antigen IgE Antibody
C13015 A. tenuis alternata Antigen A. tenuis alternata Antigen IgG AB A measurement of the Alternaria Alternaria tenuis alternata
2 IgG AB tenuis alternata antigen IgG Antigen IgG Antibody
C13015 A. tenuis alternata Antigen A. tenuis alternata Antigen IgG4 AB A measurement of the Alternaria Alternaria tenuis alternata
3 IgG4 AB tenuis alternata antigen IgG4 Antigen IgG4 Antibody
C11112 Abnormal Cells Abnormal Cells A measurement of the abnormal Abnormal Cell Count
4 cells in a biological specimen.
C15083 Abnormal Cells/Leukocytes Abnormal Cells/Leukocytes A relative measurement (ratio or Abnormal Cells to
4 percentage) of abnormal cells to Leukocytes Ratio
leukocytes in a biological Measurement
specimen.
C15083 Abnormal Cells/Total Cells Abnormal Cells/Total Cells A relative measurement (ratio or Abnormal Cells to Total
5 percentage) of abnormal cells to Cells Ratio Measurement
total cells in a biological specimen.
C13539 ABO A1 Subtype ABO A1 Subtype The characterization of the ABO ABO A1 Subtype
7 blood group A1 subtype in an Determination
individual. (NCI)
C12593 ABO Blood Group ABO Blood Group The characterization of the blood ABO Blood Group
9 type of an individual by testing for Determination
the presence of A antigen and B
antigen on the surface of red
blood cells.
C74699 Acanthocytes Acanthocytes A measurement of the Acanthocyte Count

acanthocytes in a biological
specimen.
C74633 Acanthocytes/Erythrocytes Acanthocytes/Erythrocytes A relative measurement (ratio or Acanthocyte to

percentage) of acanthocytes to all Erythrocyte Ratio
erythrocytes in a biological Measurement
specimen.
C13539 Acetaminophen Acetaminophen;Paracetamol A measurement of the Acetaminophen

8 acetaminophen in a biological Measurement
specimen.
C92247 Acetoacetic Acid Acetoacetate;Acetoacetic Acid A measurement of the acetoacetic Acetoacetic Acid
acid in a biological specimen. Measurement
C14728 Acetone Acetone A measurement of the acetone in Acetone Measurement

8 a biological specimen.
C74838 Acetylcholine Acetylcholine A measurement of the Acetylcholine

acetylcholine hormone in a Measurement
C96559 Acetylcholine Receptor Acetylcholine Receptor Antibody A measurement of the Acetylcholine Receptor
Antibody acetylcholine receptor antibody in Antibody Measurement
page 770 of 1925

C6715 LBTEST
4
Code Value
C96560 Acetylcholinesterase Acetylcholinesterase A measurement of the Acetylcholinesterase

acetylcholinesterase in a biological Measurement
specimen.
C14729 ACH Receptor Modulatn ACH Receptor Modulation Antibody/ACH Receptor A relative measurement (ratio or Acetylcholine Receptor
7 Ab/ACH Receptor Ab Antibody;ACH Receptor Modulatn Ab/ACH percentage) of the acetylcholine Modulation Antibody to
Receptor Ab receptor modulation antibody to Acetylcholine Receptor
the total acetylcholine receptor Antibody Ratio
antibodies in a biological Measurement
specimen.
C80163 Acid Phosphatase Acid Phosphatase A measurement of the acid Acid Phosphatase
phosphatase in a biological Measurement
specimen.
C74912 Acid Urate Crystals Acid Urate Crystals A measurement of the acid urate Acid Urate Crystal
crystals present in a biological Measurement
specimen.
C10334 Activated Coagulation Activated Clotting Time;Activated Coagulation A measurement of the inhibition of Activated Coagulation
8 Time Time blood coagulation in response to Time
anticoagulant therapies.
C38462 Activated Partial Activated Partial Thromboplastin Time A measurement of the length of Partial Thromboplastin
Thromboplastin Time time that it takes for clotting to Time
occur when reagents are added to
a plasma specimen. The test is
partial due to the absence of
tissue factor (Factor III) from the
reaction mixture.
C10047 Activated Protein C Activated Protein C Resistance;Factor V Leiden A measurement of the resistance Activated Protein C
1 Resistance Screen in the anticoagulation response to Resistance Measurement
activated protein C in a biological
specimen.
C98862 Activated PTT/Standard Activated PTT/Standard;Activated PTT/Standard A relative measurement (ratio or Activated PTT/Standard
PTT;Activated Partial Thromboplastin percentage) of the subject's partial Ratio Measurement
Time/Standard Thromboplastin Time thromboplastin time to a standard
or control partial thromboplastin
time.
C11221 Active Ghrelin Active Ghrelin A measurement of active ghrelin in Active Ghrelin
9 a biological specimen. Measurement
C92286 Acyl Coenzyme A Oxidase Acyl CoA Oxidase;Acyl Coenzyme A A measurement of the acyl Acyl Coenzyme A Oxidase
Oxidase;Fatty Acyl Coenzyme A Oxidase coenzyme A oxidase in a biological Measurement
specimen.
C14728 Acylcarnitine/Carnitine, Acylcarnitine/Carnitine, Free A relative measurement (ratio or Acylcarnitine to Free

9 Free percentage) of the acylcarnitine to Carnitine Ratio
free carnitine in a biological Measurement
specimen.
C14729 ADAM Metallopeptidase A Disintegrin And Metalloproteinase Domain A measurement of the ADAM ADAM Metallopeptidase
0 Domain 8 8;ADAM Metallopeptidase Domain 8;CD156a metallopeptidase domain 8 protein Domain 8 Measurement
Antigen in a biological specimen.
C10225 Adenosine Diphosphate Adenosine Diphosphate A measurement of the adenosine Adenosine Diphosphate
7 diphosphate in a biological Measurement
specimen.
C14730 Adenosine Triphosphate Adenosine Triphosphate A measurement of the adenosine Adenosine Triphosphate
7 triphosphate in a biological Measurement
specimen.
C11112 Adenovirus Antibody Adenovirus Antibody A measurement of the adenovirus Adenovirus Antibody
5 antibody in a biological specimen. Measurement
C74839 Adiponectin Adiponectin A measurement of the total Adiponectin Measurement

adiponectin hormone in a
C13236 Adiponectin, High Adiponectin, High Molecular Weight A measurement of the high High Molecular Weight
3 Molecular Weight molecular weight adiponectin Adiponectin Measurement
hormone in a biological specimen.
C74780 Adrenocorticotropic Adrenocorticotropic Hormone;Corticotropin A measurement of the Adrenocorticotropic

Hormone adrenocorticotropic hormone in a Hormone Measurement
page 771 of 1925

C6715 LBTEST
4
Code Value
C11222 Aggrecan Chondroitin 846-Epitope;Aggrecan Chondroitin Sulfate A measurement of the 846 epitope Aggrecan Chondroitin
0 Sulfate Epitope 846 Epitope 846;CS846;Chondroitin Sulfate Epitope present on the chondroitin sulfate Sulfate Epitope 846
846;Chondroitin Sulfate Proteoglycan 1 Epitope chains of aggrecan in a biological Measurement
846 specimen.
C11620 Agranular Neutrophils Agranular Neutrophils A measurement of the agranular Agranular Neutrophils
0 neutrophils in a biological Measurement
specimen.
C12209 Alanine Alanine A measurement of the alanine in a Alanine Measurement

1 biological specimen.
C10043 Alanine Aminopeptidase Alanine Aminopeptidase A measurement of the alanine Alanine Aminopeptidase
0 aminopeptidase in a biological Measurement
specimen.
C64433 Alanine Aminotransferase Alanine Aminotransferase;SGPT A measurement of the alanine Alanine Aminotransferase
aminotransferase in a biological Measurement
specimen.
C64431 Albumin Albumin;Microalbumin A measurement of the albumin Albumin Measurement

protein in a biological specimen.
C14729 Albumin Clearance Albumin Clearance A measurement of the albumin Albumin Clearance
3 clearance in a biological specimen.
C15081 Albumin Excretion Rate Albumin Excretion Rate A measurement of the amount of Albumin Excretion Rate
4 albumin excreted in a biological
specimen over a defined period of
time (e.g. one hour).
C15473 Albumin Index Albumin Index;CSF/Serum Albumin Index A relative measurement (ratio) of Albumin Index
4 the albumin in cerebrospinal fluid
to albumin in serum in a biological
specimen.
C74761 Albumin/Creatinine Albumin/Creatinine;Microalbumin/Creatinine A relative measurement (ratio) of Albumin To Creatinine

Ratio the albumin to the creatinine in a Protein Ratio Measurement
C74894 Albumin/Globulin Albumin/Globulin The ratio of albumin to globulin in Albumin to Globulin Ratio
C10345 Albumin/Total Protein Albumin/Total Protein A relative measurement (ratio or Albumin to Total Protein
3 percentage) of the albumin to total Ratio Measurement
C74731 Aldolase Aldolase A measurement of the aldolase Aldolase Measurement

enzyme in a biological specimen.
C74841 Aldosterone Aldosterone A measurement of the aldosterone Aldosterone Measurement

C12433 Aldosterone/Renin Activity Aldosterone/Renin Activity A relative measurement (ratio) of Aldosterone to Renin
8 the aldosterone to renin activity in Activity Ratio
C15474 Aldrin Epoxidase Aldrin Epoxidase A measurement of the aldrin Aldrin Epoxidase
3 epoxidase in a biological Measurement
specimen.
C14729 Alk Phos, Bone/Total Alk Alk Phos, Bone/Total Alk Phos;Alkaline A relative measurement (ratio or Bone Alkaline Phosphatase
4 Phos Phosphatase, Bone/Total Alkaline Phosphatase percentage) of the bone specific to Total Alkaline
alkaline phosphatase isoform to Phosphatase Ratio
total alkaline phosphatase in a Measurement
C14729 Alk Phos, Intestinal/Total Alk Phos, Intestinal/Total Alk Phos;Alkaline A relative measurement (ratio or Intestinal Alkaline
5 Alk Phos Phosphatase, Intestinal/Total Alkaline percentage) of the intestinal Phosphatase to Total
Phosphatase specific alkaline phosphatase Alkaline Phosphatase Ratio
isoform to total alkaline Measurement
phosphatase in a biological
specimen.
C14729 Alk Phos, Liver/Total Alk Alk Phos, Liver/Total Alk Phos;Alkaline A relative measurement (ratio or Liver Alkaline Phosphatase
6 Phos Phosphatase, Liver/Total Alkaline Phosphatase percentage) of the liver specific to Total Alkaline
alkaline phosphatase isoform to Phosphatase Ratio
total alkaline phosphatase in a Measurement
C64432 Alkaline Phosphatase Alkaline Phosphatase A measurement of the alkaline Alkaline Phosphatase
phosphatase in a biological Measurement
specimen.
page 772 of 1925

C6715 LBTEST
4
Code Value
C13909 Alkaline Phosphatase Alkaline Phosphatase Isoenzyme A measurement of the alkaline Alkaline Phosphatase
1 Isoenzyme phosphatase isoenzyme in a Isoenzyme Measurement
C79438 Alkaline Alkaline Phosphatase/Creatinine A relative measurement (ratio or Alkaline Phosphatase to

Phosphatase/Creatinine percentage) of the alkaline Creatinine Ratio
phosphatase to creatinine in a Measurement
C15476 Alloisoleucine Alloisoleucine A measurement of the Alloisoleucine

2 alloisoleucine in a biological Measurement
specimen.
C74732 Alpha Fetoprotein Alpha Fetoprotein;Alpha-1-Fetoprotein A measurement of the alpha Alpha-fetoprotein

fetoprotein in a biological Measurement
specimen.
C10649 Alpha Fetoprotein Activity Alpha Fetoprotein Activity A measurement of the alpha Alpha Fetoprotein Activity
9 fetoprotein activity in a biological Measurement
specimen.
C14729 Alpha Fetoprotein Adj for Alpha Fetoprotein Adj for Body Weight A measurement of alpha Alpha Fetoprotein
1 Body Weight fetoprotein, which has been Adjusted for Body Weight
adjusted for body weight, in a Measurement
C96562 Alpha Fetoprotein L1 Alpha Fetoprotein L1 A measurement of the alpha Alpha Fetoprotein L1
fetoprotein L1 in a biological Measurement
specimen.
specimen.
specimen.
C79433 Alpha Glutathione-S- Alpha Glutathione-S-Transferase A measurement of the alpha form Alpha Glutathione-S-
Transferase of glutathione S-transferase in a Transferase Measurement
C11112 Alpha Hydroxybutyrate Alpha Hydroxybutyrate Dehydrogenase A measurement of the alpha- Alpha Hydroxybutyrate
6 Dehydrogenase hydroxybutyrate dehydrogenase in Dehydrogenase
C14227 Alpha Synuclein Protein Alpha Synuclein Protein A measurement of the alpha Alpha Synuclein Protein
2 synuclein protein in a biological Measurement
specimen.
C10334 Alpha Tocopherol Alpha Tocopherol A measurement of the alpha Alpha Tocopherol
9 tocopherol in a biological Measurement
specimen.
C10335 Alpha Tocopherol/Vitamin Alpha Tocopherol/Vitamin E A relative measurement (ratio or Alpha Tocopherol to
0 E percentage) of alpha-tocopherol to Vitamin E Ratio
the total vitamin E in a biological Measurement
specimen.
C10042 Alpha-1 Acid Glycoprotein Alpha-1 Acid Glycoprotein A measurement of the alpha-1 Alpha-1 Acid Glycoprotein
9 acid glycoprotein in a biological Measurement
specimen.
C80167 Alpha-1 Antitrypsin Alpha-1 Antitrypsin;Serum Trypsin Inhibitor A measurement of the alpha-1 Alpha-1 Antitrypsin
antitrypsin in a biological Measurement
specimen.
C92252 Alpha-1 Globulin A1-Globulin;Alpha-1 Globulin A measurement of the proteins Alpha-1 Globulin
contributing to the alpha 1 fraction Measurement
C92253 Alpha-1 Globulin/Total Alpha-1 Globulin/Total Protein A relative measurement (ratio or Alpha-1 Globulin to Total
Protein percentage) of alpha-1-fraction Protein Ratio Measurement
proteins to total proteins in a
C10046 Alpha-1 Microglobulin Alpha-1 Microglobulin;Protein HC A measurement of the alpha-1 Alpha-1 Microglobulin
1 microglobulin in a biological Measurement
specimen.
page 773 of 1925

C6715 LBTEST
4
Code Value
C10046 Alpha-1 Alpha-1 Microglobulin/Creatinine A relative measurement (ratio or Alpha-1 Microglobulin to

2 Microglobulin/Creatinine percentage) of the alpha-1 Creatinine Ratio
microglobulin to creatinine in a Measurement
C10335 Alpha-2 Antiplasmin Alpha-2 Antiplasmin;Alpha-2 Plasmin Inhibitor A measurement of the alpha-2 Alpha-2 Antiplasmin
1 antiplasmin in a biological Measurement
specimen.
C12209 Alpha-2 Antiplasmin Alpha-2 Antiplasmin Activity A measurement of the alpha-2 Alpha-2 Antiplasmin
4 Activity antiplasmin activity in a biological Activity Measurement
specimen.
C92254 Alpha-2 Globulin A2-Globulin;Alpha-2 Globulin A measurement of the proteins Alpha-2 Globulin
contributing to the alpha 2 fraction Measurement
C92255 Alpha-2 Globulin/Total Alpha-2 Globulin/Total Protein A relative measurement (ratio or Alpha-2 Globulin to Total
Protein percentage) of alpha-2-fraction Protein Ratio Measurement
C80168 Alpha-2 Macroglobulin Alpha-2 Macroglobulin A measurement of the alpha-2 Alpha-2 Macroglobulin
macroglobulin in a biological Measurement
specimen.
C15476 Alpha-Aminoadipic Acid Alpha-Aminoadipate;Alpha-Aminoadipic Acid A measurement of the alpha- Alpha-Aminoadipic Acid
1 aminoadipic acid in a biological Measurement
specimen.
C15475 Alpha-Aminobutyric Acid Alpha-Aminobutyric Acid;Alpha- A measurement of the alpha- Alpha-Aminobutyric Acid
9 aminobutyrate;Homocitrulline aminobutyric acid in a biological Measurement
specimen.
C11927 Alpha-GST Excretion Rate Alpha-GST Excretion Rate A measurement of the amount of Alpha-GST Excretion Rate
8 Alpha Glutathione-S-Transferase
being excreted in a biological
specimen over a defined period of
time (e.g. one hour).
C13236 Alpha-Methylacyl Alpha-Methylacyl Coenzyme A Racemase A measurement of the alpha- Alpha-Methylacyl

4 Coenzyme A Racemase methylacyl coenzyme A racemase Coenzyme A Racemase
in a biological specimen. Measurement
C14729 Alpha-N- Alpha-N-acetylglucosaminidase A measurement of the alpha-N- Alpha-N-

9 acetylglucosaminidase acetylglucosaminidase in a acetylglucosaminidase
C75370 Alprazolam Alprazolam A measurement of the alprazolam Alprazolam Measurement

present in a biological specimen.
C10649 ALT/AST ALT/AST A relative measurement (ratio or Alanine Aminotransferase

8 percentage) of the alanine to Aspartate
aminotransferase (ALT) to Aminotransferase Ratio
aspartate aminotransferase (AST) Measurement
present in a sample.
C11112 Aluminum Al;Aluminum A measurement of aluminum in a Aluminum Measurement

C13236 AMACR mRNA AMACR mRNA A measurement of the alpha- Alpha-Methylacyl

5 methylacyl coenzyme A racemase Coenzyme A Racemase
mRNA in a biological specimen. mRNA Measurement
C13013 American Cockroach American Cockroach Antigen IgA Antibody A measurement of the Periplaneta American Cockroach
7 Antigen IgA Antibody americana antigen IgA antibody in Antigen IgA Antibody
C13013 American Cockroach American Cockroach Antigen IgE Antibody A measurement of the Periplaneta American Cockroach
6 Antigen IgE Antibody americana antigen IgE antibody in Antigen IgE Antibody
C13013 American Cockroach American Cockroach Antigen IgG Antibody A measurement of the Periplaneta American Cockroach
8 Antigen IgG Antibody americana antigen IgG antibody in Antigen IgG Antibody
C13013 American Cockroach American Cockroach Antigen IgG4 Antibody A measurement of the Periplaneta American Cockroach
9 Antigen IgG4 Antibody americana antigen IgG4 antibody Antigen IgG4 Antibody
C74799 Ammonia Ammonia;NH3 A measurement of the ammonia in Ammonia Measurement

page 774 of 1925

C6715 LBTEST
4
Code Value
C10559 Ammonium Biurate Acid Ammonium Urate Crystals;Ammonium A measurement of the ammonium Ammonium Biurate
0 Crystals Biurate Crystals;Ammonium Urate Crystals biurate crystals present in a Crystals Measurement
C74759 Ammonium Oxalate Ammonium Oxalate Crystals A measurement of the ammonium Urine Ammonium Oxalate
Crystals oxalate crystals present in a urine Crystal Measurement
specimen.
C75363 Amobarbital Amobarbital A measurement of the amobarbital Amobarbital Measurement

C74665 Amorphous Crystals Amorphous Crystals A measurement of the amorphous Amorphous Crystal
(Note: phosphate or urate, Measurement
depending on pH) crystals present
C92243 Amorphous Phosphate Amorphous Phosphate Crystals A measurement of the amorphous Amorphous Phosphate
Crystals phosphate crystals in a biological Crystals Measurement
specimen.
C74666 Amorphous Sediment Amorphous Debris;Amorphous Sediment A measurement of the amorphous Amorphous Sediment
sediment present in a biological Measurement
specimen.
C92244 Amorphous Urate Crystals Amorphous Urate Crystals A measurement of the amorphous Amorphous Urate Crystals
urate crystals in a biological Measurement
specimen.
C74687 Amphetamine Amphetamine A measurement of any Amphetamine Drug Class

amphetamine class drug present Measurement
C64434 Amylase Amylase A measurement of the total Amylase Measurement

enzyme amylase in a biological
specimen.
C98767 Amylase, Pancreatic Amylase, Pancreatic A measurement of the pancreatic Pancreatic Amylase
enzyme amylase in a biological Measurement
specimen.
C98780 Amylase, Salivary Amylase, Salivary A measurement of the salivary Salivary Amylase
enzyme amylase in a biological Measurement
specimen.
C12594 Amyloid A Amyloid A;Serum Amyloid A A measurement of the total Amyloid A Measurement
0 amyloid a (official name is Serum
Amyloid A) in a biological
specimen.
C11926 Amyloid Alpha Precursor Amyloid Alpha Precursor Protein A measurement of the amyloid Amyloid Alpha Precursor
8 Protein alpha precursor protein present in Protein Measurement
C10335 Amyloid Beta 1-38 Amyloid Beta 1-38;Amyloid Beta 38;Amyloid A measurement of amyloid beta Amyloid Beta 1-38
2 Beta 38 Protein protein which is composed of Measurement
peptides 1 to 38 in a biological
specimen.
C10335 Amyloid Beta 1-40 Amyloid Beta 1-40;Amyloid Beta 40;Amyloid A measurement of amyloid beta Amyloid Beta 1-40
3 Beta 40 Protein protein which is composed of Measurement
specimen.
C84809 Amyloid Beta 1-42 Amyloid Beta 1-42;Amyloid Beta 42;Amyloid A measurement of amyloid beta Beta Amyloid 42
Beta 42 Protein protein which is composed of Measurement
specimen.
C10543 Amyloid Beta Precursor Amyloid Beta Precursor;Amyloid Beta Precursor A measurement of the amyloid Amyloid Beta Precursor
8 Protein Protein;Amyloid Precursor Beta;Amyloid beta precursor protein present in a Protein Measurement
Precursor Protein biological specimen.
C81998 Amyloid P Amyloid P A measurement of the total Amyloid P Measurement

amyloid P in a biological specimen.
C81999 Amyloid, Beta Amyloid, Beta;Beta Amyloid A measurement of the total Beta Amyloid
amyloid beta in a biological Measurement
specimen.
C14729 Anabasine Anabasine A measurement of the anabasine Anabasine Measurement

8 in a biological specimen.
page 775 of 1925

C6715 LBTEST
4
Code Value
C74842 Androstenediol Androstenediol A measurement of the Androstenediol Metabolite

androstenediol metabolite in a Measurement
C74843 Androstenedione 4-Androstenedione;Androstenedione A measurement of the Androstenedione

androstenedione hormone in a Measurement
C11112 Angiopoietin 1 Angiopoietin 1 A measurement of angiopoietin 1 Angiopoietin 1

8 in a biological specimen. Measurement
C80169 Angiotensin Converting Angiotensin Converting Enzyme A measurement of the angiotensin Angiotensin Converting
Enzyme converting enzyme in a biological Enzyme Measurement
specimen.
C74844 Angiotensin I Angiotensin I A measurement of the angiotensin Angiotensin I

I hormone in a biological Measurement
specimen.
C74845 Angiotensin II Angiotensin II A measurement of the angiotensin Angiotensin II

II hormone in a biological Measurement
specimen.
C74846 Angiotensinogen Angiotensin Precursor;Angiotensinogen A measurement of the Angiotensinogen

angiotensinogen hormone in a Measurement
C13011 Animal Mix Antigen IgE Animal Mix Antigen IgE Antibody A measurement of the animal mix Animal Mix Antigen IgE
2 Antibody antigen IgE antibody in a Antibody Measurement
C13011 Animal Mix Antigen IgG Animal Mix Antigen IgG Antibody A measurement of the animal mix Animal Mix Antigen IgG
3 Antibody antigen IgG antibody in a Antibody Measurement
C74685 Anion Gap Anion Gap A computed estimate of the Anion Gap Measurement
unmeasured anions (those other
than the chloride and bicarbonate
anions) in a biological specimen.
C14730 Anion Gap 3 Anion Gap 3 A computed estimate of the Anion Gap 3 Measurement
3 unmeasured anions (computed as
sodium minus the chloride and
bicarbonate) in a biological
specimen.
C14730 Anion Gap 4 Anion Gap 4 A computed estimate of the Anion Gap 4 Measurement
4 unmeasured anions (computed as
the difference between the sum of
serum sodium + serum potassium
and the sum of the serum
bicarbonate+ chloride) in a
C74797 Anisocytes Anisocytes;Anisocytosis A measurement of the variability Anisocyte Measurement

in the size of the red blood cells in
a whole blood specimen.
C81973 Anti-DNA Antibodies Anti-DNA Antibodies;Anti-ds-DNA Antibodies A measurement of the anti-DNA Anti-DNA Antibody
specimen.
C74913 Anti-Double Stranded DNA Anti-Double Stranded DNA A measurement of the anti-double Anti-Double Stranded DNA
stranded DNA antibody in a Measurement
C15476 Anti-Double Stranded DNA Anti-Double Stranded DNA IgG A measurement of the double Anti-Double Stranded DNA
9 IgG stranded DNA IgG antibody in a IgG Measurement
C98706 Anti-Factor Xa Activity Anti-Factor Xa Activity A measurement of the ability of Anti-Factor Xa Activity
antithrombin to inactivate Measurement
activated Factor X in a biological
specimen. This test is used to
monitor low molecular weight or
unfractionated heparin levels in a
C12062 Anti-Mullerian Hormone Anti-Mullerian Hormone A measurement of the anti- Anti-Mullerian Hormone
5 Mullerian hormone in a biological Measurement
specimen.
page 776 of 1925

C6715 LBTEST
4
Code Value
C12062 Anti-Neutrophil Anti-Neutrophil Cytoplasmic Antibody A measurement of the anti- Anti-Neutrophil

6 Cytoplasmic Antibody neutrophil cytoplasmic antibody in Cytoplasmic Antibody
C12062 Anti-Nucleosome Antibody Anti-Nucleosome Antibody A measurement of the anti- Anti-Nucleosome Antibody
7 nucleosome antibody in a Measurement
C12433 Anti-Phospholipid IgG Anti-Phospholipid IgG Antibody A measurement of the Anti-Phospholipid IgG
5 Antibody antiphospholipid IgG antibody in a Antibody Measurement
C12433 Anti-Phospholipid IgM Anti-Phospholipid IgM Antibody A measurement of the Anti-Phospholipid IgM
6 Antibody antiphospholipid IgM antibody in a Antibody Measurement
C81976 Anti-Saccharomyces Anti-Saccharomyces cerevisiae Antibody A measurement of the anti- Anti-Saccharomyces

cerevisiae Antibody Saccharomyces cerevisiae cerevisiae Antibody
C92269 Anti-Single Stranded DNA Anti-Single Stranded DNA IgG A measurement of the anti-single Anti-Single Stranded DNA
IgG stranded DNA IgG antibody in a IgG Measurement
C74691 Antidepressants Antidepressants A measurement of any Antidepressant

antidepressant class drug present Measurement
C74847 Antidiuretic Hormone Antidiuretic Hormone;Vasopressin A measurement of the antidiuretic Antidiuretic Hormone
hormone in a biological specimen. Measurement
C81974 Antiglobulin Test, Direct Antiglobulin Test Polyspecific, Direct;Antiglobulin A measurement of the antibody or Direct Antiglobulin Test
Test, Direct;Direct Coombs Test complement-coated erythrocytes
in a biological specimen in vivo.
C91372 Antiglobulin Test, Indirect Antiglobulin Test, Indirect;Indirect Coombs Test A test that uses Coombs' reagent Indirect Antiglobulin Test
to detect the presence of anti-
erythrocyte antibodies in a
C81975 Antimitochondrial Antimitochondrial Antibodies;Mitochondrial A measurement of the Antimitochondrial Antibody

Antibodies Antibody antimitochondrial antibodies in a Measurement
C74916 Antinuclear Antibodies Antinuclear Antibodies A measurement of the total Antinuclear Antibody
antinuclear antibodies (antibodies Measurement
that attack the body's own tissue)
C12209 Antinuclear IgG Antibody Antinuclear IgG Antibody A measurement of the antinuclear Antinuclear IgG Antibody
3 IgG antibody in a biological Measurement
specimen.
C10225 Antiphospholipid Antiphospholipid Antibodies A measurement of the total Antiphospholipid Antibody

8 Antibodies antiphospholipid antibodies in a Measurement
C81958 Antithrombin Antithrombin;Antithrombin Activity;Antithrombin A measurement of the Antithrombin Activity

III;Antithrombin III Activity antithrombin activity in a biological Measurement
specimen.
C14730 Antithrombin Activity Antithrombin Activity Actual/Antithrombin A relative measurement (ratio or Antithrombin Activity
6 Actual/Control Activity Control;Antithrombin Activity percentage) of the biological Actual to Control Ratio
Actual/Control;Antithrombin Activity activity of antithrombin in a Measurement
Actual/Normal subject's specimen when
compared to the same activity in a
control specimen.
C81977 Antithrombin Antigen Antithrombin Antigen;Antithrombin III Antigen A measurement of the Antithrombin Antigen
antithrombin antigen in a Measurement
C12433 Apolipoprotein A Apolipoprotein A A measurement of the total Apolipoprotein A

7 apolipoprotein A in a biological Measurement
specimen.
C74733 Apolipoprotein A1 Apolipoprotein A1 A measurement of the Apolipoprotein A1

apolipoprotein A1 in a biological Measurement
specimen.
page 777 of 1925

C6715 LBTEST
4
Code Value
C14729 Apolipoprotein Apolipoprotein A1/Apolipoprotein B A relative measurement (ratio or Apolipoprotein A1 to

2 A1/Apolipoprotein B percentage) of the Apolipoprotein Apolipoprotein B Ratio
A1 to Apolipoprotein B in a Measurement

4 apolipoprotein A4 in a biological Measurement
specimen.

5 apolipoprotein A5 in a biological Measurement
specimen.
C82000 Apolipoprotein AII Apolipoprotein AII A measurement of the Apolipoprotein AII

apolipoprotein AII in a biological Measurement
specimen.
C74734 Apolipoprotein B Apolipoprotein B A measurement of the total Apolipoprotein B

apolipoprotein B in a biological Measurement
specimen.
C10335 Apolipoprotein Apolipoprotein B/Apolipoprotein A1 A relative measurement (ratio or Apolipoprotein B to

6 B/Apolipoprotein A1 percentage) of the Apolipoprotein Apolipoprotein A1 Ratio
B to Apolipoprotein A1 in a Measurement
C12062 Apolipoprotein B100 Apolipoprotein B100 A measurement of the Apolipoprotein B100

8 apolipoprotein B100 in a biological Measurement
specimen.
C12062 Apolipoprotein B48 Apolipoprotein B48 A measurement of the Apolipoprotein B48

9 apolipoprotein B48 in a biological Measurement
specimen.
C10042 Apolipoprotein C2 Apolipoprotein C2;Apolipoprotein CII A measurement of the Apolipoprotein C2

7 apolipoprotein C2 in a biological Measurement
specimen.
C12063 Apolipoprotein CI Apolipoprotein CI A measurement of the Apolipoprotein CI

0 apolipoprotein CI in a biological Measurement
specimen.
C82001 Apolipoprotein CIII Apolipoprotein CIII A measurement of the Apolipoprotein CIII

apolipoprotein CIII in a biological Measurement
specimen.
C82002 Apolipoprotein E Apolipoprotein E A measurement of the Apolipoprotein E

apolipoprotein E in a biological Measurement
specimen.
C92293 Apolipoprotein E4 Apolipoprotein E4 A measurement of the Apolipoprotein E4

apolipoprotein E4 in a biological Measurement
specimen.
C82003 Apolipoprotein H Apolipoprotein H A measurement of the Apolipoprotein H

apolipoprotein H in a biological Measurement
specimen.
C10042 Apolipoprotein J Apolipoprotein J;Clusterin A measurement of the Apolipoprotein J

8 apolipoprotein J in a biological Measurement
specimen.
C11113 Apolipoprotein J/Creatinine Apolipoprotein J/Creatinine;Clusterin/Creatinine A relative measurement (ratio or Apolipoprotein J to

0 percentage) of the apolipoprotein J Creatinine Ratio
to creatinine in a biological Measurement
specimen.
C10225 Arachidonic Acid Arachidonic Acid A measurement of the arachidonic Arachidonic Acid
9 acid present in a biological Measurement
specimen.
C14727 Arachis hypogaea Antigen Arachis hypogaea Antigen IgE Antibody;Peanut A measurement of the Arachis Arachis hypogaea Antigen
6 IgE Antibody Antigen IgE Antibody hypogaea antigen IgE antibody in IgE Antibody Measurement
C12209 Arginine Arginine A measurement of the arginine in Arginine Measurement

C15476 Argininosuccinic Acid Argininosuccinate;Argininosuccinic Acid A measurement of the Argininosuccinic Acid

3 argininosuccinic acid in a biological Measurement
specimen.
page 778 of 1925

C6715 LBTEST
4
Code Value
C14730 Arsenic Arsenic;As A measurement of the arsenic in a Arsenic Measurement

C12209 Asparagine Asparagine A measurement of the asparagine Asparagine Measurement

C64467 Aspartate Aspartate Aminotransferase;SGOT A measurement of the aspartate Aspartate

Aminotransferase aminotransferase in a biological Aminotransferase
specimen. Measurement
C81978 Aspartate Aspartate Aminotransferase Antigen;SGOT A measurement of the aspartate Aspartate

Aminotransferase Antigen Antigen aminotransferase antigen in a Aminotransferase Antigen
C11783 Aspartate Aspartate Aminotransferase/Creatinine A relative measurement (ratio or Aspartate

0 Aminotransferase/Creatini percentage) of the aspartate Aminotransferase to
ne aminotransferase to creatinine in a Creatinine Ratio
C12209 Aspartic Acid Aspartate;Aspartic Acid A measurement of the aspartic Aspartic Acid
7 acid in a biological specimen. Measurement
C15472 Atherogenic Index of AIP;Atherogenic Index;Atherogenic Index of A measurement of the base 10 Atherogenic Index of
6 Plasma Plasma logarithm of the ratio of molar Plasma
concentration of plasma
triglyceride to high density
lipoprotein cholesterol in a
C74886 Atrial Natriuretic Peptide Atrial Natriuretic Peptide;Atriopeptin A measurement of the atrial Atrial Natriuretic Peptide
natriuretic peptide in a biological Measurement
specimen.
C74657 Auer Rods Auer Rods A measurement of the Auer rods Auer Rod Measurement
(elongated needle structures that
are found in the cytoplasm of
leukemic blasts and are formed by
clumps of azurophilic granular
material) in a biological specimen.
C11618 Azurophilic Granules Azurophilic Granulation;Azurophilic Granules An observation of azurophilic Azurophilic Granule
5 granules in a biological specimen. Measurement
C11113 B-Cell Activating Factor B-Cell Activating Factor A measurement of the B-cell B-Cell Activating Factor
5 activating factor in a biological Measurement
specimen.
C12895 B-lymphocyte Crossmatch B-lymphocyte Crossmatch A measurement to determine B-lymphocyte Crossmatch

1 human leukocyte antigens (HLA) Measurement
histocompatibility between the
recipient and the donor by
examining the presence or
absence of the recipient's anti-HLA
antibody reactivity towards HLA
antigens expressed on the donor
B-lymphocytes.
C14731 B. burgdorferi IgG and IgM B. burgdorferi IgG and IgM Antibody;Borrelia A measurement of the Borrelia Borrelia burgdorferi IgG
0 Antibody burgdorferi IgG and IgM Antibody burgdorferi IgG and IgM and IgM Antibody
specimen.
C64469 Bacteria Bacteria A measurement of the bacteria in Bacterial Count

C74762 Bacterial Casts Bacterial Casts A measurement of the bacterial Bacterial Cast
casts present in a biological Measurement
specimen.
C12063 Bactericidal/Permeability- BPI Auto-antibody;Bactericidal/Permeability-Inc A measurement of the Bactericidal/Permeability-

1 Inc Protein Ab Protein Ab bactericidal/permeability- Increasing Protein
increasing protein antibody in a Antibody Measurement
C74688 Barbiturates Barbiturates A measurement of any barbiturate Barbiturate Drug Class

class drug present in a biological Measurement
specimen.
C14730 Base Deficit Base Deficit A measurement of the amount of Base Deficit
9 alkali required to return a
biological specimen to a normal pH
under standard conditions.
page 779 of 1925

C6715 LBTEST
4
Code Value
C11927 Base Excess Actual Base Excess;Base Excess A calculated measurement of the Base Excess Measurement
0 amount of acid required to return
blood to a normal pH under
standard conditions.
C14731 Basophilic Erythroblast Basophilic Erythroblast A measurement of the basophilic Basophilic Erythroblast
1 erythroblasts in a biological Count
specimen taken from a non-
human organism.
C13539 Basophilic Metamyelocytes Basophilic Metamyelocytes A measurement of the basophilic Basophilic Metamyelocyte
9 metamyelocytes in a biological Count
specimen.
C13540 Basophilic Myelocytes Basophilic Myelocytes A measurement of the basophilic Basophilic Myelocyte
0 myelocytes in a biological Count
specimen.
C14740 Basophilic Normoblast Basophilic Normoblast A measurement of the basophilic Basophilic Normoblast
5 normoblasts in a biological Count
specimen taken from a non-
human organism.
C96567 Basophilic Stippling Basophilic Stippling A measurement of the basophilic Basophilic Stippling
stippling in a biological specimen. Measurement
C64470 Basophils Basophils A measurement of the basophils in Total Basophil Count

C13015 Basophils Band Form Basophils Band Form A measurement of the banded Basophil Band Form Count
4 basophils in a biological specimen.
C13015 Basophils Band Basophils Band Form/Leukocytes A relative measurement (ratio or Basophil Band Form to
5 Form/Leukocytes percentage) of the banded Leukocytes Ratio
basophils to leukocytes in a Measurement
C13540 Basophils, Segmented Basophils, Segmented A measurement of the segmented Segmented Basophil Count
1 basophils in a biological specimen.
C64471 Basophils/Leukocytes Basophils/Leukocytes A relative measurement (ratio or Basophil to Leukocyte

percentage) of the basophils to Ratio
leukocytes in a biological
specimen.
C98865 Basophils/Total Cells Basophils/Total Cells A relative measurement (ratio or Basophil to Total Cell Ratio
percentage) of the basophils to Measurement
total cells in a biological specimen
(for example a bone marrow
specimen).
C13011 Bee Mix Antigen IgE Bee Mix Antigen IgE Antibody A measurement of the bee mix Bee Mix Antigen IgE
C13011 Bee Mix Antigen IgG Bee Mix Antigen IgG Antibody A measurement of the bee mix Bee Mix Antigen IgG
C13011 Bee Mix Antigen IgG4 Bee Mix Antigen IgG4 Antibody A measurement of the bee mix Bee Mix Antigen IgG4
8 Antibody antigen IgG4 antibody in a Antibody Measurement
C11113 Bence-Jones Protein Bence-Jones Protein A measurement of the total Bence-Jones Protein
6 Bence-Jones protein in a biological Measurement
specimen.
C74692 Benzodiazepine Benzodiazepine A measurement of any Benzodiazepine

benzodiazepine class drug present Measurement
C75350 Benzoylecgonine Benzoylecgonine;Cocaine Metabolite A measurement of the Benzoylecgonine

benzoylecgonine in a biological Measurement
specimen.
C13006 Bermuda Grass Pollen IgA Bermuda Grass Pollen IgA A measurement of the Cynodon Bermuda Grass Pollen IgA
9 dactylon pollen antigen IgA Measurement
antibody in a biological specimen.
C13006 Bermuda Grass Pollen IgE Bermuda Grass Pollen IgE A measurement of the Cynodon Bermuda Grass Pollen IgE
8 dactylon pollen antigen IgE Measurement
page 780 of 1925

C6715 LBTEST
4
Code Value
C13007 Bermuda Grass Pollen IgG Bermuda Grass Pollen IgG A measurement of the Cynodon Bermuda Grass Pollen IgG
0 dactylon pollen antigen IgG Measurement
C13007 Bermuda Grass Pollen Bermuda Grass Pollen IgG4 A measurement of the Cynodon Bermuda Grass Pollen
1 IgG4 dactylon pollen antigen IgG4 IgG4 Measurement
C15476 Beta Alanine Beta Alanine A measurement of the beta Beta Alanine Measurement
4 alanine in a biological specimen.
C10047 Beta Carotene Beta Carotene;Beta Carotin;b-Carotene A measurement of the beta Beta Carotene
2 carotene in a biological specimen. Measurement
C10335 Beta Catenin Beta Catenin A measurement of the beta Beta Catenin Measurement
7 catenin in a biological specimen.
C92256 Beta Globulin Beta Globulin A measurement of the proteins Beta Globulin
contributing to the beta fraction in Measurement
C92294 Beta Globulin/Total Protein Beta Globulin/Total Protein A relative measurement (ratio or Beta Globulin to Total
percentage) of beta fraction Protein Ratio Measurement
C11927 Beta-1 Globulin Beta-1 Globulin A measurement of the beta-1 Beta-1 Globulin
4 globulin in a biological specimen. Measurement
C14227 Beta-1 Globulin/Beta Beta-1 Globulin/Beta Protein A relative measurement (ratio or Beta-1 Globulin to Total
7 Protein percentage) of the beta-1-fraction Beta Protein Ratio
proteins to the total beta protein Measurement
fraction in a biological specimen.
C11927 Beta-1 Globulin/Total Beta-1 Globulin/Total Protein A relative measurement (ratio or Beta-1 Globulin to Total
5 Protein percentage) of beta-1-fraction Protein Ratio Measurement
C12760 Beta-1B Glycoprotein Beta-1B Glycoprotein;HPX;Hemopexin A measurement of the beta-1B Beta-1B Glycoprotein
7 glycoprotein in a biological Measurement
specimen.
C11927 Beta-2 Globulin Beta-2 Globulin A measurement of the beta-2 Beta-2 Globulin
6 globulin in a biological specimen. Measurement
C11927 Beta-2 Globulin/Total Beta-2 Globulin/Total Protein A relative measurement (ratio or Beta-2 Globulin to Total
7 Protein percentage) of beta-2-fraction Protein Ratio Measurement
C14730 Beta-2 Glycoprotein 1 IgA Beta-2 Glycoprotein 1 IgA Antibody A measurement of the beta-2 Beta-2 Glycoprotein 1 IgA
8 Antibody glycoprotein 1 IgG antibodies in a Antibody Measurement
C10335 Beta-2 Glycoprotein 1 IgG Beta-2 Glycoprotein 1 IgG Antibody A measurement of the Beta-2 Beta-2 Glycoprotein 1 IgG
8 Antibody glycoprotein 1 IgG antibodies in a Antibody Measurement
C10335 Beta-2 Glycoprotein 1 IgM Beta-2 Glycoprotein 1 IgM Antibody A measurement of the Beta-2 Beta-2 Glycoprotein 1 IgM
9 Antibody glycoprotein 1 IgM antibodies in a Antibody Measurement
C81979 Beta-2 Glycoprotein Beta-2 Glycoprotein Antibody A measurement of the beta-2 Beta-2 Glycoprotein
Antibody glycoprotein antibody in a Antibody Measurement
C81980 Beta-2 Microglobulin Beta-2 Microglobulin A measurement of the beta-2 Beta-2 Microglobulin
microglobulin in a biological Measurement
specimen.
C12760 Beta-2 Beta-2 Microglobulin/Creatinine A relative measurement (ratio) of Beta-2 Microglobulin to

8 Microglobulin/Creatinine the beta-2 microglobulin to Creatinine Ratio
creatinine in a biological specimen. Measurement
C15476 Beta-Aminobutyric Acid BABA;Beta-Aminobutyric Acid;Beta- A measurement of the beta- Beta-Aminobutyric Acid
5 aminobutyrate aminobutyric acid in a biological Measurement
specimen.
C12345 Beta-cell Function Beta-cell Function A measurement of the beta cell Beta-Cell Function
5 function (insulin production and Measurement
secretion) in a biological
specimen.
page 781 of 1925

C6715 LBTEST
4
Code Value
C12210 Beta-defensin 2 Beta-defensin 2 A measurement of the beta- Beta-defensin 2

2 defensin 2 in a biological Measurement
specimen.
C96568 Beta-Hydroxybutyrate 3-Hydroxybutyrate;B-Hydroxybutyrate;Beta- A measurement of the total Beta- Beta-Hydroxybutyrate

Hydroxybutyrate hydroxybutyrate in a biological Measurement
specimen.
C10042 Beta-Trace Protein Beta-Trace Protein A measurement of the beta-trace Beta-Trace Protein
6 protein in a biological specimen. Measurement
C74667 Bicarbonate Bicarbonate;HCO3 A measurement of the bicarbonate Bicarbonate Measurement

C74800 Bile Acid Bile Acid;Bile Acids;Bile Salt;Bile Salts A measurement of the total bile Bile Acid Measurement
acids in a biological specimen.
C38037 Bilirubin Bilirubin;Total Bilirubin A measurement of the total Total Bilirubin

bilirubin in a biological specimen. Measurement
C74668 Bilirubin Crystals Bilirubin Crystals A measurement of the bilirubin Bilirubin Crystal
specimen.
C11786 Bioavailable Testosterone Bioavailable Testosterone A measurement of bioavailable Bioavailable Testosterone

0 testosterone in a biological Measurement
specimen.
C13007 Birch Pollen IgA Birch Pollen IgA A measurement of the Betula Birch Pollen IgA
3 pollen antigen IgA antibody in a Measurement
C13007 Birch Pollen IgE Birch Pollen IgE A measurement of the Betula Birch Pollen IgE
2 pollen antigen IgE antibody in a Measurement
C13007 Birch Pollen IgG Birch Pollen IgG A measurement of the Betula Birch Pollen IgG
4 pollen antigen IgG antibody in a Measurement
C13007 Birch Pollen IgG4 Birch Pollen IgG4 A measurement of the Betula Birch Pollen IgG4
5 pollen antigen IgG4 antibody in a Measurement
C74700 Bite Cells Bite Cells A measurement of the bite cells Bite Cell Count
(erythrocytes with the appearance
of a bite having been removed,
due to oxidative hemolysis) in a
C74634 Bite Cells/Erythrocytes Bite Cells/Erythrocytes A relative measurement (ratio or Bite Cell to Erythrocyte
percentage) of bite cells Ratio Measurement
(erythrocytes with the appearance
of a bite having been removed,
due to oxidative hemolysis) to all
erythrocytes in a biological
specimen.
C15473 Bizarre Platelets Bizarre Platelets A measurement of the bizarre Bizarre Platelet Count
3 platelets (large with abnormal
morphology and shape) in a
C74605 Blasts Blasts A measurement of the blast cells Blast Count

C64487 Blasts/Leukocytes Blasts/Leukocytes A relative measurement (ratio or Blast to Leukocyte Ratio

percentage) of the blasts to
specimen.
C14731 Blasts/Nucleated Cells Blasts/Nucleated Cells A relative measurement (ratio or Blasts to Nucleated Cells
2 percentage) of the blasts to the Ratio Measurement
total nucleated cells in a biological
specimen.
C15083 Blasts/Total Cells Blasts/Total Cells A relative measurement (ratio or Blasts to Total Cells Ratio
6 percentage) of the blasts to total Measurement
cells in a biological specimen.
C89775 Bleeding Time Bleeding Time;Clotting Time Homeostasis A measurement of the time from Bleeding Time
the start to cessation of an
induced bleed.
page 782 of 1925

C6715 LBTEST
4
Code Value
C12760 Blister Cell Blister Cell A measurement of the blister cells Blister Cell Count
C92287 Bone Specific Alkaline Bone Specific Alkaline Phosphatase A measurement of the bone Bone Specific Alkaline
Phosphatase specific alkaline phosphatase Phosphatase Measurement
isoform in a biological specimen.
C12209 Borrelia burgdorferi Borrelia burgdorferi Antibody;Lyme Antibody A measurement of the total Borrelia Burgdorferi
8 Antibody Borrelia burgdorferi antibody in a Antibody Measurement
C12209 Borrelia burgdorferi IgA Borrelia burgdorferi IgA Antibody;Lyme IgA A measurement of the Borrelia Borrelia Burgdorferi IgA
9 Antibody Antibody burgdorferi IgA antibody in a Antibody Measurement
C12210 Borrelia burgdorferi IgG Borrelia burgdorferi IgG Antibody;Lyme IgG A measurement of the Borrelia Borrelia Burgdorferi IgG
0 Antibody Antibody burgdorferi IgG antibody in a Antibody Measurement
C12210 Borrelia burgdorferi IgM Borrelia burgdorferi IgM Antibody;Lyme IgM A measurement of the Borrelia Borrelia Burgdorferi IgM
1 Antibody Antibody burgdorferi IgM antibody in a Antibody Measurement
C14728 Boxelder Pollen IgE Boxelder Pollen IgE Antibody A measurement of the Acer Boxelder Pollen IgE
4 Antibody negundo pollen antigen IgE Antibody Measurement
C74735 Brain Natriuretic Peptide B-Type Natriuretic Peptide;Brain Natriuretic A measurement of the brain (B- Brain Natriuretic Peptide
Peptide type) natriuretic peptide in a Measurement
C82004 Brain-Derived Brain-Derived Neurotrophic Factor A measurement of the brain- Brain-Derived

Neurotrophic Factor derived neurotrophic factor in a Neurotrophic Factor
C96588 Broad Casts Broad Casts A measurement of the broad casts Broad Casts Measurement
C75352 Buprenorphine Buprenorphine A measurement of the Buprenorphine

buprenorphine drug present in a Measurement
C74701 Burr Cells Burr Cells A measurement of the Burr cells Burr Cell Count
(erythrocytes characterized by the
presence of small, blunt
projections evenly distributed
across the cell surface) in a
C75365 Butalbital Butalbital A measurement of the butalbital Butalbital Measurement

C11114 Butyrylcholinesterase Acylcholine A measurement of the total Butyrylcholinesterase

2 Acylhydrolase;Butyrylcholinesterase;Non- butyrylcholinesterase in a Measurement
neuronal Cholinesterase;Plasma biological specimen.
Cholinesterase;Pseudocholinesterase
C64548 C Reactive Protein C Reactive Protein A measurement of the C reactive C-Reactive Protein
protein in a biological specimen. Measurement
C12210 C-C Chemokine Receptor C-C Chemokine Receptor Type 5;CD195 A measurement of the CCR5, C-C Chemokine Receptor
3 Type 5 chemokine (C-C motif) receptor Type 5 Measurement
type 5, in a biological specimen.
C74736 C-peptide C-peptide A measurement of the C C-peptide Measurement

(connecting) peptide of insulin in a
C15083 C-peptide/Creatinine C-peptide/Creatinine A relative measurement (ratio or C-peptide to Creatinine

7 percentage) of the C-peptide to Ratio Measurement
creatinine in a biological specimen.
C74702 Cabot Rings Cabot Rings A measurement of the Cabot rings Cabot Ring Count
(red-purple staining, threadlike,
ring or figure 8 shaped filaments
in an erythrocyte) in a biological
specimen.
C75346 Caffeine Caffeine A measurement of the caffeine in Caffeine Measurement

C12594 Calbindin Calbindin A measurement of the total Calbindin Measurement

2 calbindin in a biological specimen.
page 783 of 1925

C6715 LBTEST
4
Code Value
C74848 Calcitonin Calcitonin A measurement of the calcitonin Calcitonin Measurement

C74849 Calcitriol Calcitriol A measurement of the calcitriol Calcitriol Measurement

C64488 Calcium Calcium A measurement of the calcium in a Calcium Measurement

C10336 Calcium - Phosphorus Calcium - Phosphorus Product A measurement of the product of Calcium and Phosphorus
0 Product the calcium and phosphate Product Measurement
measurements in a biological
specimen.
C74669 Calcium Carbonate Calcium Carbonate Crystals A measurement of the calcium Calcium Carbonate Crystal
Crystals carbonate crystals present in a Measurement
C96589 Calcium Clearance Calcium Clearance A measurement of the volume of Calcium Clearance
serum or plasma that would be Measurement
cleared of calcium by excretion of
urine for a specified unit of time
(e.g. one minute).
C11927 Calcium Corrected Calcium Corrected A measurement of calcium, which Calcium Corrected
2 has been corrected using an Measurement
unspecified protein, in a biological
specimen.
C14731 Calcium Corrected for Calcium Corrected for Total Protein A measurement of calcium, which Calcium Corrected for
4 Total Protein has been corrected for total Total Protein Measurement
protein, in a biological specimen.
C15081 Calcium Excretion Rate Calcium Excretion Rate A measurement of the amount of Calcium Excretion Rate
5 calcium being excreted in a
biological specimen over a defined
period of time (e.g. one hour).
C74670 Calcium Oxalate Crystals Calcium Oxalate Crystals A measurement of the calcium Calcium Oxalate Crystal
oxalate crystals present in a Measurement
C74671 Calcium Phosphate Calcium Phosphate Crystals A measurement of the calcium Calcium Phosphate Crystal
Crystals phosphate crystals present in a Measurement
C12434 Calcium Sulfate Crystals Calcium Sulfate Crystals A measurement of the calcium Calcium Sulfate Crystals
0 sulfate crystals present in a Measurement
C96590 Calcium Sulphate Calcium Sulphate A measurement of the calcium Calcium Sulphate
sulphate in a biological specimen. Measurement
C15475 Calcium, Albumin Albumin Corrected Calcium A measurement of calcium, which Albumin Corrected
3 Corrected has been corrected for albumin, in Calcium Measurement
C81948 Calcium, Ionized Calcium, Ionized A measurement of the ionized Ionized Calcium
calcium in a biological specimen. Measurement
C12594 Calcium, Ionized pH Calcium, Ionized pH Adjusted A measurement of the pH adjusted Ionized pH Adjusted
1 Adjusted ionized calcium in a biological Calcium Measurement
specimen.
C79439 Calcium/Creatinine Calcium/Creatinine A relative measurement (ratio or Calcium to Creatinine

percentage) of the calcium to Ratio Measurement
C13908 Calcium/Phosphorus Calcium/Phosphate;Calcium/Phosphorus A relative measurement (ratio) of Calcium to Phosphorus

7 the calcium to phosphorus in a Ratio Measurement
page 784 of 1925

C6715 LBTEST
4
Code Value
C13238 Calculated Panel Reactive Calculated Panel Reactive Antibody A measurement of the calculated Calculated Panel Reactive
1 Antibody panel reactive antibody, which is Antibody Measurement
based on the number/type of
unacceptable HLA antigens to
which an organ recipient has been
sensitized, and which
algorithmically estimates the level
of sensitization in the recipient.
The CPRA is computed from HLA
antigen frequencies in a given
donor population using both anti-
HLA class I and class II antibody
specificities; it also represents the
percentage of actual organ donors
that express one or more
unacceptable HLA antigens to
which a recipient may react
adversely.
C82005 Calprotectin Calprotectin A measurement of the calprotectin Calprotectin Measurement

C10336 Cancer Antigen 1 Cancer Antigen 1 A measurement of the cancer Cancer Antigen 1
1 antigen 1 in a biological specimen. Measurement
C79089 Cancer Antigen 125 Cancer Antigen 125 A measurement of the cancer CA-125 Measurement
antigen 125 in a biological
specimen.
C10336 Cancer Antigen 15-3 Cancer Antigen 15-3 A measurement of the cancer Cancer Antigen 15-3
2 antigen 15-3 in a biological Measurement
specimen.
antigen 19-9 in a biological Measurement
specimen.
3 antigen 27-29 in a biological Measurement
specimen.
C10650 Cancer Antigen 72-4 CA 72-4;Cancer Antigen 72-4;Carbohydrate A measurement of the cancer Cancer Antigen 72-4
5 Antigen 72-4 antigen 72-4 in a biological Measurement
specimen.
C74689 Cannabinoids Cannabinoids A measurement of any Cannabinoid Drug Class

cannabinoid class drug present in Measurement
C13540 Cannabinoids, Synthetic Cannabinoids, Synthetic A measurement of any synthetic Synthetic Cannabinoid
2 cannabinoid class drug present in Measurement
C12594 Carb-Deficient Carb-Deficient Transferrin/Transferrin A relative measurement (ratio or Carbohydrate-Deficient

3 Transferrin/Transferrin percentage) of the carbohydrate- Transferrin to Transferrin
deficient transferrin to total Ratio Measurement
transferrin in a biological
specimen.
C14732 Carbamazepine Carbamazepine A measurement of the Carbamazepine

2 carbamazepine in a biological Measurement
specimen.
C10101 Carbohydrate-Deficient Carbohydrate-Deficient Transferrin A measurement of transferrin with Carbohydrate-Deficient

6 Transferrin a reduced number of carbohydrate Transferrin Measurement
moieties in a biological specimen.
C64545 Carbon Dioxide Carbon Dioxide A measurement of the carbon Carbon Dioxide
dioxide gas in a biological Measurement
specimen.
C13908 Carbon Monoxide Carbon Monoxide A measurement of the carbon Carbon Monoxide
4 monoxide in a biological specimen. Measurement
C96591 Carboxyhemoglobin Carboxyhemoglobin A measurement of the Carboxyhemoglobin

carboxyhemoglobin, carbon Measurement
monoxide-bound hemoglobin, in a
C14735 Carboxyhemoglobin/Total Carboxyhemoglobin/Total Hemoglobin A relative measurement (ratio or Carboxyhemoglobin to

5 Hemoglobin percentage) of the amount of Total Hemoglobin Ratio
carboxyhemoglobin compared to Measurement
total hemoglobin in a biological
specimen.
page 785 of 1925

C6715 LBTEST
4
Code Value
C81983 Carcinoembryonic Antigen Carcinoembryonic Antigen A measurement of the Carcinoembryonic Antigen

carcinoembryonic antigen in a Measurement
C12211 Cardiolipin IgA Antibody Cardiolipin IgA Antibody A measurement of the cardiolipin Cardiolipin IgA Antibody
2 IgA antibody in a biological Measurement
specimen.
C11114 Cardiolipin IgG Antibody Anti-Cardiolipin IgG Antibody;Cardiolipin IgG A measurement of the cardiolipin Cardiolipin IgG Antibody
4 Antibody IgG antibody in a biological Measurement
specimen.
C10336 Cardiolipin IgM Antibody Cardiolipin IgM Antibody A measurement of the cardiolipin Cardiolipin IgM Antibody
3 IgM antibodies in a biological Measurement
specimen.
C74682 Carnitine Carnitine A measurement of the total Total Carnitine

carnitine in a biological specimen. Measurement
C92288 Carnitine Acetyl Carnitine Acetyl Transferase A measurement of the carnitine Carnitine Acetyl
Transferase acetyl transferase in a biological Transferase Measurement
specimen.
C14732 Carnitine Esters Carnitine Esters A measurement of the total Carnitine Ester
3 carnitine esters in a biological Measurement
specimen.
C74677 Carnitine, Free Carnitine, Free A measurement of the free Free Carnitine
carnitine in a biological specimen. Measurement
C11114 Cartilage Oligomeric Matrix Cartilage Oligomeric Matrix Protein A measurement of the cartilage Cartilage Oligomeric
5 Protein oligomeric matrix protein in a Matrix Protein
C74763 Casts Casts A statement that indicates casts Cast Present Or Absent
were looked for in a biological
specimen.
C13012 Cat Dander Antigen IgA Cat Dander Antigen IgA Antibody A measurement of the Felis catus Cat Dander Antigen IgA
6 Antibody dander antigen IgA antibody in a Antibody Measurement
C13012 Cat Dander Antigen IgE Cat Dander Antigen IgE Antibody A measurement of the Felis catus Cat Dander Antigen IgE
4 Antibody dander antigen IgE antibody in a Antibody Measurement
C13012 Cat Dander Antigen IgG Cat Dander Antigen IgG Antibody A measurement of the Felis catus Cat Dander Antigen IgG
5 Antibody dander antigen IgG antibody in a Antibody Measurement
C13012 Cat Dander Antigen IgG4 Cat Dander Antigen IgG4 Antibody A measurement of the Felis catus Cat Dander Antigen IgG4
7 Antibody dander antigen IgG4 antibody in a Antibody Measurement
C12063 Cathepsin Antibody Cathepsin Antibody A measurement of the total Cathepsin Antibody
4 cathepsin antibody in a biological Measurement
specimen.
C10336 CD1 CD1 A count of the CD1 expressing CD1 Expressing Cell
4 cells per unit of a biological Measurement
specimen.
C11114 CD10 CD10 A measurement of the CD10 CD10 Expressing Cell

6 expressing cells per unit in a Count
C10543 CD11A CD11A;CD11a A count of the CD11a expressing CD11A Expressing Cell
9 cells per unit of a biological Count
specimen.
C10544 CD11B CD11B;CD11b;Complement Component 3 A count of the CD11b expressing CD11B Expressing Cell
0 Receptor 3 Subunit;Complement Receptor Type cells per unit of a biological Count
3 Alpha Subunit;ITGAM Protein;Integrin Alpha-M specimen.

specimen.
page 786 of 1925

C6715 LBTEST
4
Code Value
C12210 CD161/Lymphocytes CD161/Lymphocytes A relative measurement (ratio or CD161 to Lymphocyte

5 percentage) of CD161 expressing Ratio Measurement
cells to all lymphocytes in a
C12210 CD161a/Lymphocytes CD161a/Lymphocytes A relative measurement (ratio or CD161a to Lymphocyte

4 percentage) of CD161a expressing Ratio Measurement
8 cells per unit in a biological Count
specimen.
C10381 CD19/Lymphocytes CD19/Lymphocytes A relative measurement (ratio or CD19 Cell to Lymphocyte

specimen.
C10336 CD2/Lymphocytes CD2/Lymphocytes A relative measurement (ratio or CD2 Expressing Cell to

7 percentage) of CD2 expressing Lymphocyte Ratio
cells to all lymphocytes in a Measurement
specimen.


C10380 CD3 CD3 A count of the CD3 expressing CD3 Expressing Cell Count
9 cells per unit in a biological
specimen.


C10226 CD34 CD34 A measurement of the CD34 CD34 Measurement

0 expressing cells per unit in a

specimen.
C10381 CD4/CD8 CD4/CD8 A relative measurement (ratio or CD4 Cell to CD8 Cell Ratio
4 percentage) of CD4 expressing Measurement
cells to the CD8 expressing cells in

C82006 CD40 CD40 A count of the CD40 cells per unit CD40 Measurement
C82007 CD40 Ligand CD40 Ligand A count of the CD40 ligand cells CD40 Ligand Measurement
per unit in a biological specimen.
page 787 of 1925

C6715 LBTEST
4
Code Value
C12210 CD45/Lymphocytes CD45/Lymphocytes A relative measurement (ratio or CD45 to Lymphocyte Ratio

6 percentage) of CD45 expressing Measurement
C12210 CD45RA/Lymphocytes CD45RA/Lymphocytes A relative measurement (ratio or CD45RA to Lymphocyte

7 percentage) of CD45RA expressing Ratio Measurement
specimen.
specimen.
C11115 CD79A CD79A A measurement of the CD79A CD79A Expressing Cell

specimen.

C48938 Cells Cells A measurement of the total cells in Cell Count

C74764 Cellular Casts Cellular Casts A measurement of the cellular Cellular Cast Measurement
(white blood cell, red blood cell,
epithelial and bacterial) casts
C11115 Cellularity Cellularity;Cellularity Grade A measurement of the degree, Cellularity Measurement

3 quality or condition of cells in a
C11115 Centromere B Antibodies Centromere B Antibodies A measurement of centromere B Centromere B Antibody

4 antibodies in a biological Measurement
specimen.
C12211 Centromere IgG Antibody Centromere IgG Antibody;Centromere Protein B A measurement of the centromere Centromere IgG Antibody
specimen.
C10043 Ceruloplasmin Caeruloplasmin;Ceruloplasmin A measurement of ceruloplasmin Ceruloplasmin

C13015 Chemokine (C-C Motif) Chemokine (C-C Motif) Ligand 12;Monocyte A measurement of the CCL12, Chemokine (C-C Motif)
6 Ligand 12 Chemotactic Protein 5 chemokine (C-C motif) ligand 12, Ligand 12 Measurement
C11223 Chemokine (C-C Motif) ABCD-2;Chemokine (C-C Motif) Ligand A measurement of the CCL17, Chemokine (C-C Motif)
6 Ligand 17 17;SCYA17;TARC;Thymus and Activation chemokine (C-C motif) ligand 17, Ligand 17 Measurement
Regulated Chemokine in a biological specimen.
C11223 Chemokine (C-C Motif) AMAC-1;AMAC1;CKB7;Chemokine (C-C Motif) A measurement of the CCL18, Chemokine (C-C Motif)
7 Ligand 18 Ligand 18;DC-CK1;DCCK1;MIP4;Macrophage chemokine (C-C motif) ligand 18, Ligand 18 Measurement
inflammatory protein-4;PARC;Pulmonary and in a biological specimen.
Activation-Regulated Chemokine;SCYA18
C13015 Chemokine (C-C Motif) Chemokine (C-C Motif) Ligand A measurement of the CCL19, Chemokine (C-C Motif)
7 Ligand 19 19;MIP3B;Macrophage Inflammatory Protein 3 chemokine (C-C motif) ligand 19, Ligand 19 Measurement
Beta in a biological specimen.
C14731 Chemokine (C-C Motif) 6Ckine;Chemokine (C-C Motif) Ligand A measurement of the CCL21, Chemokine (C-C Motif)
5 Ligand 21 21;Secondary Lymphoid Tissue Chemokine chemokine (C-C motif) ligand 21, Ligand 21 Measurement
C13015 Chemokine (C-C Motif) Chemokine (C-C Motif) Ligand 7;MCP3;Monocyte A measurement of the CCL7, Chemokine (C-C Motif)
8 Ligand 7 Chemotactic Protein 3 chemokine (C-C motif) ligand 7, in Ligand 7 Measurement
C12895 Chemokine (C-X-C Motif) Chemokine (C-X-C Motif) Ligand 1;GRO A measurement of the CXCL1, Chemokine (C-X-C Motif)
2 Ligand 1 Alpha;GRO/KC;Melanoma Growth Stimulating chemokine (C-X-C motif) ligand 1, Ligand 1 Measurement
Activity, Alpha in a biological specimen.
page 788 of 1925

C6715 LBTEST
4
Code Value
C11223 Chemokine (C-X-C Motif) Chemokine (C-X-C Motif) Ligand 10;IP- A measurement of the CXCL10, Chemokine (C-X-C Motif)
8 Ligand 10 10;Interferon Gamma-induced Protein 10;Small- chemokine (C-X-C motif) ligand Ligand 10 Measurement
inducible Cytokine B10 10, in a biological specimen.
C14732 Chemokine (C-X-C Motif) B Lymphocyte Chemoattractant;Chemokine (C- A measurement of the CXCL13, Chemokine (C-X-C Motif)
8 Ligand 13 X-C Motif) Ligand 13 chemokine (C-X-C motif) ligand Ligand 13 Measurement
13, in a biological specimen.
C14732 Chemokine (C-X-C Motif) Chemokine (C-X-C Motif) Ligand 3;GRO A measurement of the CXCL3, Chemokine (C-X-C Motif)
9 Ligand 3 Gamma;MIP2 Beta;MIP2B;Macrophage chemokine (C-X-C motif) ligand 3, Ligand 3 Measurement
Inflammatory Protein 2-Beta in a biological specimen.
C14733 Chemokine (C-X-C Motif) Chemokine (C-X-C Motif) Ligand 4;Oncostatin A measurement of the CXCL4, Chemokine (C-X-C Motif)
0 Ligand 4 A;PLF4;Platelet Factor 4 chemokine (C-X-C motif) ligand 4, Ligand 4 Measurement
C13015 Chemokine (C-X-C Motif) Chemokine (C-X-C Motif) Ligand A measurement of the CXCL6, Chemokine (C-X-C Motif)
9 Ligand 6 6;GCP2;Granulocyte Chemotactic Protein 2 chemokine (C-X-C motif) ligand 6, Ligand 6 Measurement
C10043 Chemokine (C-X-C Motif) CD183;CXCR3;Chemokine (C-X-C Motif) A measurement of the CXCR3, Chemokine Receptor
1 Receptor 3 Receptor 3;GPR9 chemokine (C-X-C motif) receptor CXCR3 Measurement
3, in a biological specimen.
C13540 Chikungunya Virus Chikungunya Virus Antibody A measurement of the Chikungunya Virus
4 Antibody Chikungunya virus antibody in a Antibody Measurement
C92432 Chlamydia pneumoniae Chlamydia pneumoniae IgA Antibody A measurement of the Chlamydia Chlamydia pneumoniae
IgA Antibody pneumoniae IgA antibody in a IgA Antibody
C92433 Chlamydia pneumoniae Chlamydia pneumoniae IgM Antibody A measurement of the Chlamydia Chlamydia pneumoniae
IgM Antibody pneumoniae IgM in a biological IgM Antibody
C10046 Chlamydia trachomatis IgA Chlamydia trachomatis IgA Antibody A measurement of the Chlamydia Chlamydia trachomatis IgA
4 Antibody trachomatis IgA antibody in a Antibody Measurement
C10046 Chlamydia trachomatis IgG Chlamydia trachomatis IgG Antibody A measurement of the Chlamydia Chlamydia trachomatis
6 Antibody trachomatis IgG antibody in a IgG Antibody
C10046 Chlamydia trachomatis Chlamydia trachomatis IgM Antibody A measurement of the Chlamydia Chlamydia trachomatis
5 IgM Antibody trachomatis IgM antibody in a IgM Antibody
C75371 Chlordiazepoxide Chlordiazepoxide A measurement of the Chlordiazepoxide

chlordiazepoxide present in a Measurement
C64495 Chloride Chloride A measurement of the chloride in Chloride Measurement

C10650 Chloride Clearance Chloride Clearance A measurement of the volume of Chloride Clearance
9 serum or plasma that would be Measurement
cleared of chloride by excretion of
(e.g. one minute).
C15081 Chloride Excretion Rate Chloride Excretion Rate A measurement of the amount of Chloride Excretion Rate
6 chloride being excreted in a
period of time (e.g. one hour).
C79440 Chloride/Creatinine Chloride/Creatinine A relative measurement (ratio or Chloride to Creatinine

percentage) of the chloride to Ratio Measurement
C74850 Cholecystokinin Cholecystokinin;Pancreozymin A measurement of the Cholecystokinin

cholecystokinin hormone in a Measurement
C11619 Cholera Toxin B Subunit Cholera Toxin B Subunit IgG Antibody A measurement of the cholera Cholera Toxin B Subunit
4 IgG Antibody toxin B subunit IgG antibody in a IgG Antibody
C10558 Cholesterol Cholesterol;Total Cholesterol A measurement of the cholesterol Cholesterol Measurement

page 789 of 1925

C6715 LBTEST
4
Code Value
C74672 Cholesterol Crystals Cholesterol Crystals A measurement of the cholesterol Cholesterol Crystal
specimen.
C80171 Cholesterol/HDL- Cholesterol/HDL-Cholesterol A relative measurement (ratio or Cholesterol to HDL-

Cholesterol percentage) of total cholesterol to Cholesterol Ratio
high-density lipoprotein Measurement
cholesterol (HDL-C) in a biological
specimen.
C12063 Cholesteryl Ester Transfer Cholesteryl Ester Transfer Protein A measurement of the cholesteryl Cholesteryl Ester Transfer
2 Protein ester transfer protein in a Protein Measurement
C10338 Cholesteryl Ester Transfer Cholesteryl Ester Transfer Protein Act A measurement of the biological Cholesteryl Ester Transfer
0 Protein Act activity of cholesteryl ester Protein Activity
transfer protein in a biological Measurement
specimen.
C92289 Cholinesterase Cholinesterase A measurement of the Cholinesterase

cholinesterase in a biological Measurement
specimen.
C14712 Choriogonadotropin Choriogonadotropin A measurement of the total Choriogonadotropin

8 choriogonadotropin in a biological Measurement
specimen.
C64851 Choriogonadotropin Beta Choriogonadotropin Beta;Pregnancy Test A measurement of the Choriogonadotropin Beta
Choriogonadotropin Beta in a Measurement
C14736 Choriogonadotropin Beta, Choriogonadotropin Beta, Free A measurement of the free Free Choriogonadotropin
0 Free choriogonadotropin beta in a Beta Measurement
C14736 Choriogonadotropin, Intact Choriogonadotropin, Intact A measurement of the intact Intact Choriogonadotropin
1 choriogonadotropin in a biological Measurement
specimen.
C14731 Chromatin Antibodies Chromatin Antibodies A measurement of the chromatin Chromatin Antibody
specimen.
C12210 Chromogranin A Chromogranin A A measurement of the Chromogranin A

8 chromogranin A in a biological Measurement
specimen.
C12063 Chylomicrons Chylomicrons A measurement of the Chylomicrons

3 chylomicrons in a biological Measurement
specimen.
C11115 Chymotrypsin Chymotrypsin A measurement of the total Chymotrypsin

9 chymotrypsin in a biological Measurement
specimen.
C96592 Circulating Endothelial Circulating Endothelial Cells A measurement of the circulating Circulating Endothelial Cell
Cells endothelial cells in a biological Count
specimen.
C12761 Circulating Immune Circulating Immune Complexes A measurement of the circulating Circulating Immune
1 Complexes immune complexes in a biological Complex Measurement
specimen.
C96593 Circulating Tumor Cells Circulating Tumor Cells A measurement of the circulating Circulating Tumor Cell
tumor cells in a biological Count
specimen.
C14732 Citalopram Citalopram A measurement of the citalopram Citalopram Measurement

7 present in a biological specimen.
C92248 Citrate Citrate;Citric Acid A measurement of the citrate in a Citrate Measurement

C12211 Citrate/Creatinine Citrate/Creatinine;Citric Acid/Creatinine A relative measurement (ratio or Citrate to Creatinine Ratio
0 percentage) of the citrate to Measurement
C12210 Citrulline Citrulline A measurement of the citrulline in Citrulline Measurement

page 790 of 1925

C6715 LBTEST
4
Code Value
C14731 CK, Macromolecular Type CK, Macromolecular Type 1/Total CK;Creatine A relative measurement (ratio or Macromolecular Type 1
9 1/Total CK Kinase, Macromolecular Type 1/Total Creatine percentage) of the Creatine Kinase to Total
Kinase macromolecular type 1 creatine Creatine Kinase Ratio
kinase to total creatine kinase in a Measurement
C14732 CK, Macromolecular Type CK, Macromolecular Type 2/Total CK;Creatine A relative measurement (ratio or Macromolecular Type 2
0 2/Total CK Kinase, Macromolecular Type 2/Total Creatine percentage) of the Creatine Kinase to Total
Kinase macromolecular type 2 creatine Creatine Kinase Ratio
kinase to total creatine kinase in a Measurement
C14728 Cladosporium herbarum Cladosporium herbarum IgE Antibody A measurement of the Cladosporium herbarum
6 IgE Antibody Cladosporium herbarum antigen IgE Antibody Measurement
IgE antibody in a biological
specimen.
C96594 Clarity Clarity A measurement of the Clarity Measurement

transparency of a biological
specimen.
C13908 Clonazepam Clonazepam A measurement of the clonazepam Clonazepam Measurement

C13907 Clorazepate Clorazepate A measurement of the clorazepate Clorazepate Measurement

C10338 Clostridium difficile Toxin Clostridium difficile Toxin A measurement of the Clostridium Clostridium difficile Toxin
1 difficile toxin in a biological Measurement
specimen.
C10338 Clostridium tetani IgG Clostridium tetani IgG Antibody A measurement of the Clostridium Clostridium tetani IgG
2 Antibody tetani IgG antibody in a biological Antibody Measurement
specimen.
C13540 Clostridium tetani Toxoid Clostridium tetani Toxoid IgG Antibody A measurement of the Clostridium Clostridium tetani Toxoid
6 IgG Antibody tetani toxoid IgG antibody in a IgG Antibody
C10226 Clue Cells Clue Cells A measurement of the clue cells in Clue Cell Count
C11223 Coagulation Index CI;Coagulation Index A measurement of the efficiency of Coagulation Index
9 coagulation of a biological Measurement
specimen. This is calculated by a
mathematical formula that takes
into account the R value, K value,
angle and maximum amplitude of
clot formation.
C74690 Cocaine Cocaine A measurement of the cocaine Cocaine Measurement

C14227 Cocaine Amphetamine-Reg CART;Cocaine Amphetamine-Reg Transcript A measurement of the cocaine and Cocaine Amphetamine-
3 Transcript Prot Prot;Cocaine and Amphetamine-Regulated amphetamine-regulated transcript Regulated Transcript
Transcript Protein protein in a biological specimen. Protein Measurement
C14227 Cocaine Benzoylecgonine Cocaine Benzoylecgonine Ecgonine A measurement of the cocaine, Cocaine, Benzoylecgonine,
4 Ecgonine benzoylecgonine, and/or ecgonine and/or Ecgonine
C11116 Coccidioides Antibody Coccidioides Antibody A measurement of the coccidioides Coccidioides Antibody
C74877 Codeine Codeine A measurement of the codeine Codeine Measurement

C10338 Collagen Type IV Collagen Type IV A measurement of the collagen Collagen Type IV
3 type IV in a biological specimen. Measurement
C64546 Color Color A measurement of the color of a Color Assessment

C13540 Columnar Epi Cells/Non- Columnar Epi Cells/Non-Squam Epi Cells A relative measurement (ratio or Columnar Epithelial Cells
5 Squam Epi Cells percentage) of the columnar to Non-Squamous
epithelial cells to non-squamous Epithelial Cells Ratio
epithelial cells in a biological Measurement
specimen.
C14728 Common Ragweed Pollen Common Ragweed Pollen IgE Antibody A measurement of the Ambrosia Common Ragweed Pollen
5 IgE Antibody elatior pollen antigen IgE antibody IgE Antibody Measurement
page 791 of 1925

C6715 LBTEST
4
Code Value
C13540 Complement Ba Ba Fragment of Complement Factor B;Ba A measurement of the Ba Complement Ba

3 Fragment of Factor B;Complement Ba fragment of complement factor B Measurement
C80172 Complement Bb Bb Fragment of Complement Factor B;Bb A measurement of the Bb Complement Bb

Fragment of Factor B;Complement Bb fragment of complement factor B Measurement
C14731 Complement C1 Esterase Complement C1 Esterase Inhibitor A measurement of the Complement C1 Esterase
3 Inhibitor complement C1 esterase inhibitor Inhibitor Measurement
C80173 Complement C1q Antibody Complement C1q Antibody A measurement of the Complement C1q Antibody
complement C1q antibody in a Measurement
C80174 Complement C3 Complement C3 A measurement of the Complement C3

complement C3 in a biological Measurement
specimen.
C80175 Complement C3a ASP, Complement C3 DesArg, Acetylation- A measurement of the Complement C3a
stimulating Protein;Complement C3a complement C3a in a biological Measurement
specimen.
C80176 Complement C3b Complement C3b A measurement of the Complement C3b

complement C3b in a biological Measurement
specimen.
C11927 Complement C3d Antibody Complement C3d Antibody A measurement of the Complement C3d Antibody
1 complement C3d antibody in a Measurement
C80177 Complement C4 Complement C4 A measurement of the Complement C4

complement C4 in a biological Measurement
specimen.
C80178 Complement C4a Complement C4a A measurement of the Complement C4a

complement C4a in a biological Measurement
specimen.
C12761 Complement C4d Complement C4d A measurement of the Complement C4d

0 complement C4d in a biological Measurement
specimen.
C80179 Complement C5a Complement C5a A measurement of the Complement C5a

complement C5a in a biological Measurement
specimen.
C14731 Complement CH100 CH100;Complement CH100 A measurement of the Complement CH100

7 complement required to lyse 100 Measurement
percent of red blood cells in a
C10042 Complement CH50 CH50;Complement CH50 A measurement of the CH50 Measurement

3 complement required to lyse 50
percent of red blood cells in a
C80160 Complement Total Complement Total A measurement of the total Complement Measurement
complement in a biological
specimen.
C12761 Copeptin Copeptin A measurement of the copeptin in Copeptin Measurement

C11116 Copper Copper;Cu A measurement of copper in a Copper Measurement

C13906 Corpuscular Hemoglobin CH;Cellular Hemoglobin Content;Corpuscular A measurement of the mean Corpuscular Hemoglobin
6 Content Hemoglobin Content erythrocyte hemoglobin content Content
within an individual erythrocyte,
calculated as the product of cell
volume and cell hemoglobin
concentration.
C13906 Corpuscular HGB Conc Corpuscular HGB Conc Distribution A measurement of the standard Corpuscular Hemoglobin
8 Distribution Width Width;Corpuscular Hemoglobin Concentration deviation of hemoglobin Concentration Distribution
Distribution Width concentrations in erythrocytes in a Width
biological specimen, calculated as
the standard deviation of
hemoglobin content divided by the
mean hemoglobin content.
page 792 of 1925

C6715 LBTEST
4
Code Value
C13906 Corpuscular HGB Corpuscular HGB Concentration Mean A direct measurement of the Corpuscular Hemoglobin
7 Concentration Mean concentration of hemoglobin Concentration Mean
within individual erythrocytes in a
biological specimen, reported as a
mean.
C79434 Corticosterone Corticosterone A measurement of corticosterone Corticosterone

C10651 Corticosterone/Creatinine Corticosterone/Creatinine A relative measurement (ratio or Corticosterone to

1 percentage) of the corticosterone Creatinine Ratio
to creatinine present in a sample. Measurement
C74851 Corticotropin Releasing Corticotropin Releasing Factor;Corticotropin A measurement of the Corticotropin Releasing
Hormone Releasing Hormone corticotropin releasing hormone in Hormone Measurement
C74781 Cortisol Cortisol;Total Cortisol A measurement of the cortisol in a Cortisol Measurement

C88113 Cortisol, Free Cortisol, Free A measurement of the free, Free Cortisol Measurement
unbound cortisol in a biological
specimen.
C10651 Cortisol/Creatinine Cortisol/Creatinine A relative measurement (ratio or Cortisol to Creatinine Ratio

2 percentage) of the cortisol to Measurement
creatinine present in a sample.
C92249 Cotinine Cotinine A measurement of the cotinine in Cotinine Measurement

C14728 Cow Milk Protein Antigen Cow Milk Protein Antigen IgE Antibody A measurement of the cow milk Cow Milk Protein Antigen
0 IgE Antibody protein antigen IgE antibody in a IgE Antibody Measurement
C64489 Creatine Kinase CPK;Creatine Kinase A measurement of the total Creatine Kinase
creatine kinase in a biological Measurement
specimen.
C64490 Creatine Kinase BB Creatine Kinase BB A measurement of the Creatine Kinase BB

homozygous B-type creatine Measurement
kinase in a biological specimen.
C79466 Creatine Kinase BB/Total Creatine Kinase BB/Total Creatine Kinase A relative measurement (ratio or Creatine Kinase BB to
Creatine Kinase percentage) of the BB-type Total Creatine Kinase Ratio
creatine kinase to total creatine Measurement
C64491 Creatine Kinase MB Creatine Kinase MB A measurement of the Creatine Kinase MB

heterozygous MB-type creatine Measurement
C79441 Creatine Kinase MB/Total Creatine Kinase MB/Total Creatine Kinase A relative measurement (ratio or Creatine Kinase MB to
Creatine Kinase percentage) of the MB-type Total Creatine Kinase Ratio
C64494 Creatine Kinase MM Creatine Kinase MM A measurement of the Creatine Kinase MM

homozygous M-type creatine Measurement
C79442 Creatine Kinase MM/Total Creatine Kinase MM/Total Creatine Kinase A relative measurement (ratio or Creatine Kinase MM to
Creatine Kinase percentage) of the MM-type Total Creatine Kinase Ratio
C64547 Creatinine Creatinine A measurement of the creatinine Creatinine Measurement

C25747 Creatinine Clearance Creatinine Clearance A measurement of the volume of Creatinine Clearance
serum or plasma that would be
cleared of creatinine by excretion
of urine for a specified unit of time
(e.g. one minute).
C14732 Creatinine Clearance Creatinine Clearance Adjusted for BSA A measurement of the volume of Creatinine Clearance
4 Adjusted for BSA serum or plasma that would be Adjusted for BSA
(e.g. one minute), adjusted for
body surface area.
page 793 of 1925

C6715 LBTEST
4
Code Value
C15084 Creatinine Clearance, Creatinine Clearance, Estimated An estimate of the volume of Estimated Creatinine
7 Estimated serum or plasma that would be Clearance
(e.g. one minute).
C15081 Creatinine Excretion Rate Creatinine Excretion Rate A measurement of the amount of Creatinine Excretion Rate
7 creatinine being excreted in a
amount of time (e.g. one hour).
C74703 Crenated Cells Crenated Cells;Echinocytes A measurement of the Burr cells Crenated Cell
(erythrocytes characterized by the Measurement
presence of multiple small, sharp
projections evenly distributed
across the cell surface) in a
C14732 Cryofibrinogen Cryofibrinogen A measurement of the Cryofibrinogen

6 cryofibrinogen in a biological Measurement
specimen.
C11116 Cryoglobulin Cryoglobulin A measurement of cryoglobulin in Cryoglobulin Measurement

C14732 Cryoglobulin Cryoglobulin Volume/Serum Volume A relative measurement (ratio or Cryoglobulin Volume to
5 Volume/Serum Volume percentage) of the volume of Serum Volume Ratio
cryoglobulin to total serum volume Measurement
C74673 Crystals Crystals A statement that indicates crystals Crystal Present Or Absent
were looked for in a biological
specimen.
C15473 CSF IgG Index CSF IgG Index;CSF Index;IgG Index A relative measurement (ratio) of IgG Index
5 the IgG to albumin in
cerebrospinal fluid to the IgG to
albumin in serum.
C12433 Cyclic Adenosine 3,5- Cyclic Adenosine 3,5-Monophosphate A measurement of cyclic Cyclic Adenosine 3,5-
9 Monophosphate adenosine 3,5-monophosphate in Monophosphate
C96595 Cyclic Citrullinated Peptide Cyclic Citrullinated Peptide Antibody A measurement of the cyclic Cyclic Citrullinated Peptide
Antibody citrullinated peptide antibody in a Antibody Measurement
C14731 Cyclic Citrullinated Peptide Cyclic Citrullinated Peptide IgG Ab;Cyclic A measurement of the cyclic Cyclic Citrullinated Peptide
6 IgG Ab Citrullinated Peptide IgG Antibody citrullinated peptide IgG antibody IgG Antibody
C11116 Cyclic Guanosine Cyclic Guanosine Monophosphate A measurement of the cyclic Cyclic Guanosine
5 Monophosphate guanosine 3,5-monophosphate in Monophosphate
C15083 Cylindroid Casts Cylindroid Casts A measurement of cylindroid casts Cylindroid Cast
8 (casts with a tapering end) in a Measurement
C14733 Cystathionine Cystathionine A measurement of the Cystathionine

1 cystathionine in a biological Measurement
specimen.
C92290 Cystatin C Cystatin C A measurement of the cystatin C Cystatin C Measurement

C10651 Cystatin C/Creatinine Cystatin C/Creatinine A relative measurement (ratio or Cystatin C to Creatinine
3 percentage) of the cystatin C to Ratio Measurement
C10544 Cystine Cystine A measurement of the cystine in a Cystine Measurement

C74674 Cystine Crystals Cystine Crystals A measurement of the cystine Cystine Crystal
specimen.
C13016 Cytokeratin 18 Fragment Cytokeratin 18 Fragment A measurement of the cytokeratin Cytokeratin 18 Fragment
0 18 fragment in a biological Measurement
specimen.
page 794 of 1925

C6715 LBTEST
4
Code Value
C10651 Cytokeratin 19 Fragment CYFRA21-1;Cytokeratin 19 Fragment 21-1 A measurement of the cytokeratin Cytokeratin 19 Fragment
4 21-1 19 fragment 21-1 in a biological 21-1 Measurement
specimen.
C96596 Cytomegalovirus IgG Cytomegalovirus IgG Antibody A measurement of the Cytomegalovirus IgG
Antibody cytomegalovirus IgG antibody in a Antibody Measurement
C96597 Cytomegalovirus IgM Cytomegalovirus IgM Antibody A measurement of the Cytomegalovirus IgM
Antibody cytomegalovirus IgM antibody in a Antibody Measurement
C11116 Cytoplasmic Basophilia Cytoplasmic Basophilia Neutrophil A measurement of the neutrophils Cytoplasmic Basophilia
6 Neutrophil in a biological specimen showing a Neutrophil Count
dark staining pattern in the
cytoplasm due to increased acidic
content.
C82621 D-Dimer D-Dimer A measurement of the d-dimers in D-Dimer Measurement

C13013 D. farinae Antigen IgE D. farinae Antigen IgE Antibody A measurement of the Dermatophagoides farinae
2 Antibody Dermatophagoides farinae antigen Antigen IgE Antibody
IgE antibody in a biological Measurement
specimen.
C13013 D. farinae Antigen IgG D. farinae Antigen IgG Antibody A measurement of the Dermatophagoides farinae
3 Antibody Dermatophagoides farinae antigen Antigen IgG Antibody
IgG antibody in a biological Measurement
specimen.
C13013 D. pteronyssinus Antigen D. pteronyssinus Antigen IgE Antibody A measurement of the Dermatophagoides
4 IgE Antibody Dermatophagoides pteronyssinus pteronyssinus Antigen IgE
antigen IgE antibody in a Antibody Measurement
C13013 D. pteronyssinus Antigen D. pteronyssinus Antigen IgG Antibody A measurement of the Dermatophagoides
5 IgG Antibody Dermatophagoides pteronyssinus pteronyssinus Antigen IgG
antigen IgG antibody in a Antibody Measurement
C64801 Dacryocytes Dacryocytes;Tear Shaped Erythrocytes;Teardrop A measurement of dacryocytes in Dacryocyte Analysis

Cells a biological specimen.
C13011 Dairy Mix Antigen IgG Dairy Mix Antigen IgG Antibody A measurement of the dairy mix Dairy Mix Antigen IgG
C11119 Degenerated Leukocytes Degenerated Leukocytes;Degenerated A measurement of the Degenerated Leukocyte

0 WBC;Degenerated White Blood Cells degenerated leukocytes Count
(leukocytes that show
deterioration in form or function)
C74852 Dehydroepiandrosterone Dehydroepiandrosterone;Dehydroisoandrosteron A measurement of the Dehydroepiandrosterone

e dehydroepiandrosterone hormone Measurement
C96629 Dehydroepiandrosterone DHEA Sulfate;DHEA-S;Dehydroepiandrosterone A measurement of the sulfated Sulfated DHEA

Sulfate Sulfate;sDHEA Dehydroepiandrosterone in a Measurement
C14733 Dengue Virus Antibody Dengue Virus Antibody A measurement of the dengue Dengue Virus Antibody
2 virus antibody in a biological Measurement
specimen.
C45781 Density Density A measurement of the Density

compactness of a biological
specimen expressed in mass per
unit volume.
C12434 Deoxyhemoglobin Deoxyhemoglobin A measurement of the Deoxyhemoglobin

3 deoxyhemoglobin, hemoglobin Measurement
without oxygen, in a biological
specimen.
C79443 Deoxypyridinoline Deoxypyridinoline A measurement of the Deoxypyridinoline

deoxypyridinoline in a biological Measurement
specimen.
page 795 of 1925

C6715 LBTEST
4
Code Value
C79444 Deoxypyridinoline/Creatini Deoxypyridinoline/Creatinine A relative measurement (ratio or Deoxypyridinoline to

ne percentage) of the Creatinine Ratio
deoxypyridinoline to creatinine in a Measurement
C13540 Deoxyribonucleic Acid Deoxyribonucleic Acid A measurement of a targeted Deoxyribonucleic Acid

9 deoxyribonucleic acid (DNA) in a Measurement
C12211 Desmoglein 1 Antibody Desmoglein 1 Antibody A measurement of the desmoglein Desmoglein 1 Antibody
4 1 antibody in a biological Measurement
specimen.
C12211 Desmoglein 3 Antibody Desmoglein 3 Antibody A measurement of the desmoglein Desmoglein 3 Antibody
specimen.
C14733 Desvenlafaxine Desvenlafaxine;O-Desmethylvenlafaxine A measurement of the Desvenlafaxine

3 desvenlafaxine present in a Measurement
C10226 Dextroamphetamine Dextroamphetamine;d-amphetamine A measurement of the Dextroamphetamine

2 dextroamphetamine in a biological Measurement
specimen.
C75372 Diazepam Diazepam A measurement of the diazepam Diazepam Measurement

C13540 Dicalcium Phosphate Dicalcium Phosphate Crystals A measurement of dicalcium Dicalcium Phosphate
7 Crystals phosphate crystals in a biological Crystals Measurement
specimen.
C74878 Dihydrocodeine Dihydrocodeine A measurement of the Dihydrocodeine

dihydrocodeine present in a Measurement
C74853 Dihydrotestosterone Androstanalone;Dihydrotestosterone A measurement of the Dihydrotestosterone

dihydrotestosterone hormone in a Measurement
C96696 Dilute Russell's Viper Dilute Russell's Viper Venom Time;Lupus A measurement of the time it Dilute Russell's Viper
Venom Time Anticoagulant Test takes a plasma sample to clot Venom Time Measurement
after adding dilute Russell's viper
venom.
C10338 Dilute Russell's Viper Dilute Russell's Viper Venom Time Ratio;Lupus A relative measurement of the Dilute Russell's Viper
6 Venom Time Ratio Anticoagulant Ratio dilute Russell's viper venom time Venom Time to Control
in a subject sample to a control Ratio Measurement
sample.
C11785 Dimorphic Erythrocyte Dimorphic Erythrocyte Population;Dimorphic RBC Examination of a biological Dimorphic Erythrocyte
3 Population Population specimen to detect the presence Population
of dimorphic erythrocyte
population.
C10338 Dipeptidyl Peptidase-4 DPPIV Activity;Dipeptidyl Peptidase-4 Activity A measurement of the biological Dipeptidyl Peptidase-4
7 Activity activity of dipeptidyl peptidase-4 Activity Measurement
C10338 Diphtheria IgG Antibody Diphtheria IgG Antibody A measurement of the Diphtheria Diphtheria IgG Antibody
8 IgG antibodies in a biological Measurement
specimen.
C64481 Direct Bilirubin Direct Bilirubin A measurement of the conjugated Direct Bilirubin
or water-soluble bilirubin in a Measurement
C13540 DNA Fragmentation Index DNA Fragmentation Index A measurement of the DNA Fragmentation Index
8 deoxyribonucleic acid
fragmentation within the nucleated
cells of a biological specimen.
C10046 DNase-B Antibody Anti-Dnase B;DNase-B Antibody A measurement of Dnase-B DNase-B Antibody
C13013 Dog Dander Antigen IgA Dog Dander Antigen IgA Antibody A measurement of the Canis lupus Dog Dander Antigen IgA
0 Antibody dander antigen IgA antibody in a Antibody Measurement
C13012 Dog Dander Antigen IgE Dog Dander Antigen IgE Antibody A measurement of the Canis lupus Dog Dander Antigen IgE
8 Antibody dander antigen IgE antibody in a Antibody Measurement
page 796 of 1925

C6715 LBTEST
4
Code Value
C13012 Dog Dander Antigen IgG Dog Dander Antigen IgG Antibody A measurement of the Canis lupus Dog Dander Antigen IgG
9 Antibody dander antigen IgG antibody in a Antibody Measurement
C13013 Dog Dander Antigen IgG4 Dog Dander Antigen IgG4 Antibody A measurement of the Canis lupus Dog Dander Antigen IgG4
1 Antibody dander antigen IgG4 antibody in a Antibody Measurement
C74610 Dohle Bodies Dohle Bodies A measurement of the Dohle Dohle Body Measurement
bodies (blue-gray, basophilic,
leukocyte inclusions located in the
peripheral cytoplasm of
neutrophils) in a biological
specimen.
C74854 Dopamine Dopamine A measurement of the dopamine Dopamine Measurement

C78139 Drug Screen Drug Screen An indication of the presence or Drug Test
absence of recreational drugs or
drugs of abuse in a biological
specimen.
C10044 DTPA Clearance DTPA Clearance A measurement of the volume of Diethylene Triamine
1 serum or plasma that would be Pentaacetic Acid Clearance
cleared of Diethylenetriamine
pentaacetate (DTPA) by excretion
(e.g. one minute).
C13544 Dysmorphic Erythrocytes Dysmorphic Erythrocytes A measurement of the dysmorphic Dysmorphic Erythrocyte
1 erythrocytes in a biological Count
specimen.
C15083 Dysmorphic Dysmorphic Erythrocytes/Erythrocytes A measurement (ratio or Dysmorphic Erythrocytes

9 Erythrocytes/Erythrocytes percentage) of dysmorphic to Erythrocytes Ratio
erythrocytes to total erythrocytes Measurement
C15473 E-selectin E-selectin A measurement of total E-selectin E-selectin Measurement

C13541 Ebola Virus IgM Antibody Ebola Virus IgM Antibody A measurement of the Ebola virus Ebola Virus IgM Antibody
0 IgM antibodies in a biological Measurement
specimen.
C10651 EBV Profile Interpretation EBV Profile Interpretation;Epstein-Barr Virus An assessment of Epstein-Barr Epstein-Barr Virus Profile
9 Antibody Profile;Epstein-Barr Virus virus infection based on a panel of Interpretation
Panel;Epstein-Barr Virus Profile Interpretation EBV antigen antibody tests.
C10042 Ecarin Clotting Time Ecarin Clotting Time A measurement of the activity of Ecarin Clotting Time
2 thrombin inhibitors in a biological Measurement
specimen based on the generation
of meizothrombin.
C96598 Eccentrocytes Eccentrocytes A measurement of the Eccentrocyte Count

eccentrocytes (erythrocytes in
which the hemoglobin is localized
to a particular portion of the cell,
noticeable as localized staining) in
C10044 EDTA Clearance EDTA Clearance A measurement of the volume of EDTA Clearance
0 serum or plasma that would be
cleared of Ethylenediamine
tetraacetic acid (EDTA) by
excretion of urine for a specified
unit of time (e.g. one minute).
C14728 Egg White Antigen IgE Egg White Antigen IgE Antibody A measurement of the egg white Egg White Antigen IgE
C64549 Elliptocytes Elliptocytes A measurement of the elliptocytes Elliptocyte Count

(elliptically shaped cell with blunt
ends and a long axis twice the
length of its short axis) in a
C10226 Endogenous Thrombin Endogenous Thrombin Potential A measurement of the total Endogenous Thrombin
6 Potential concentration of thrombin Potential Measurement
generated in the presence of a
substrate in a plasma or blood
sample.
page 797 of 1925

C6715 LBTEST
4
Code Value
C14733 Endomysial IgA Antibody Endomysium IgA Antibody A measurement of the endomysial Endomysial IgA Antibody
4 IgA antibody in a biological Measurement
specimen.
C82008 Endothelin-1 Endothelin-1 A measurement of the endothelin- Endothelin-1 Measurement

C13008 English Plantain Pollen IgA English Plantain Pollen IgA A measurement of the Plantagio English Plantain Pollen IgA
5 lanceolata pollen antigen IgA Measurement
C13008 English Plantain Pollen IgE English Plantain Pollen IgE A measurement of the Plantagio English Plantain Pollen IgE
4 lanceolata pollen antigen IgE Measurement
C13008 English Plantain Pollen IgG English Plantain Pollen IgG A measurement of the Plantagio English Plantain Pollen IgG
6 lanceolata pollen antigen IgG Measurement
C13008 English Plantain Pollen English Plantain Pollen IgG4 A measurement of the Plantagio English Plantain Pollen
7 IgG4 lanceolata pollen antigen IgG4 IgG4 Measurement
C84819 Eosinophilic Eosinophilic Metamyelocytes A measurement of the eosinphilic Eosinophilic

Metamyelocytes metamyelocytes in a biological Metamyelocyte Count
specimen.
C84821 Eosinophilic Myelocytes Eosinophilic Myelocytes A measurement of the eosinophilic Eosinophilic Myelocyte
myelocytes in a biological Count
specimen.
C64550 Eosinophils Eosinophils A measurement of the eosinophils Eosinophil Count

C11421 Eosinophils Band Form Eosinophils Band Form A measurement of the banded Eosinophil Band Form
6 eosinophils in a biological Count
specimen.
C11421 Eosinophils Band Eosinophils Band Form/Leukocytes A relative measurement (ratio or Eosinophil Band Form to
7 Form/Leukocytes percentage) of the banded Leukocyte Ratio
eosinophils to leukocytes in a
C13541 Eosinophils, Segmented Eosinophils, Segmented A measurement of the segmented Segmented Eosinophil
2 eosinophils in a biological Count
specimen.
C64604 Eosinophils/Leukocytes Eosinophils/Leukocytes A relative measurement (ratio or Eosinophil to Leukocyte

percentage) of the eosinophils to Ratio
specimen.
C13541 Eosinophils/Non-Squam Eosinophils/Non-Squam Epi Cells A relative measurement (ratio or Eosinophils to Non-
1 Epi Cells percentage) of the eosinophils to Squamous Epithelial Cells
non-squamous epithelial cells in a Ratio Measurement
C15084 Eosinophils/Nucleated Eosinophils/Nucleated Cells A relative measurement (ratio or Eosinophils to Nucleated

0 Cells percentage) of eosinophils to Cells Ratio Measurement
nucleated cells in a biological
specimen.
C98720 Eosinophils/Total Cells Eosinophils/Total Cells A relative measurement (ratio or Eosinophils to Total Cell
percentage) of the eosinophils to Ratio Measurement
specimen).
C81952 Eotaxin-1 Chemokine Ligand 11;Eotaxin-1 A measurement of the eotaxin-1 in Eotaxin-1 Measurement
C81953 Eotaxin-2 Chemokine Ligand 24;Eotaxin-2 A measurement of the eotaxin-2 in Eotaxin-2 Measurement
C81954 Eotaxin-3 CCL26;Chemokine (C-C Motif) Ligand A measurement of the eotaxin-3 in Eotaxin-3 Measurement
26;Chemokine Ligand 26;Eotaxin-3 a biological specimen.
C13541 Epi Cells/Non-Squam Epi Epi Cells/Non-Squam Epi Cells A relative measurement (ratio or Epithelial Cells to Non-
4 Cells percentage) of the epithelial cells Squamous Epithelial Cells
to non-squamous epithelial cells in Ratio Measurement
page 798 of 1925

C6715 LBTEST
4
Code Value
C82009 Epidermal Growth Factor Epidermal Growth Factor A measurement of the epidermal Epidermal Growth Factor
growth factor in a biological Measurement
specimen.
C11227 Epidermal Growth Factor ERBB1;Epidermal Growth Factor Receptor;HER1 A measurement of the cells with Epidermal Growth Factor
3 Receptor positive expression of EGFR in a Receptor Measurement
C79445 Epinephrine Adrenaline;Epinephrine A measurement of the epinephrine Epinephrine Measurement

C82010 Epith Neutrophil-Activating Epith Neutrophil-Activating Peptide 78 A measurement of the epithelial Epithelial Neutrophil-
Peptide 78 neutrophil-activating peptide in a Activating Peptide 78
C74779 Epithelial Casts Epithelial Casts A measurement of the epithelial Epithelial-Cast

cell casts present in a biological Measurement
specimen.
C64605 Epithelial Cells Epithelial Cells A measurement of the epithelial Epithelial Cell Count
C13016 Epithelial Cells/Total Cells Epithelial Cells/Total Cells A relative measurement (ratio or Epithelial Cells to Total
1 percentage) of the epithelial cells Cells Ratio Measurement
to total cells in a biological
specimen.
C96600 Epstein-Barr Capsid IgG Epstein-Barr Capsid IgG Antibody A measurement of the Epstein- Epstein-Barr Capsid IgG
Antibody Barr capsid IgG antibody in a Antibody Measurement
C96601 Epstein-Barr Capsid IgM Epstein-Barr Capsid IgM Antibody A measurement of the Epstein- Epstein-Barr Capsid IgM
Antibody Barr capsid IgM antibody in a Antibody Measurement
C96602 Epstein-Barr Early Antigen Epstein-Barr Early Antigen A measurement of the Epstein- Epstein-Barr Early Antigen
Barr early antigen in a biological Measurement
specimen.
C12211 Epstein-Barr Early D Epstein-Barr Early D Antigen IgG Ab A measurement of the Epstein- Epstein-Barr Early D
6 Antigen IgG Ab Barr early diffuse antigen IgG Antigen IgG Antibody
C96603 Epstein-Barr Nuclear Epstein-Barr Nuclear Antibody;Epstein-Barr A measurement of the Epstein- Epstein-Barr Nuclear
Antibody Nuclear Antigen Antibody Barr nuclear antibody in a Antibody Measurement
C96604 Epstein-Barr Nuclear Epstein-Barr Nuclear Antigen A measurement of the Epstein- Epstein-Barr Nuclear
Antigen Barr nuclear antigen in a biological Antigen Measurement
specimen.
C10651 Epstein-Barr Nuclear Epstein-Barr Nuclear Antigen 1 IgG Ab A measurement of the Epstein- Epstein-Barr Nuclear
8 Antigen 1 IgG Ab Barr nuclear antigen 1 IgG Antigen 1 IgG Ab
C64797 Ery. Mean Corpuscular Ery. Mean Corpuscular Hemoglobin A measurement of the mean Erythrocyte Mean
Hemoglobin amount of hemoglobin per Corpuscular Hemoglobin
erythrocyte in a biological
specimen, calculated as the
product of hemoglobin times ten,
divided by the number of
erythrocytes.
C64798 Ery. Mean Corpuscular Ery. Mean Corpuscular HGB Concentration An indirect measurement of the Erythrocyte Mean
HGB Concentration average concentration of Corpuscular Hemoglobin
hemoglobin per erythrocyte in a Concentration
the ratio of hemoglobin to
hematocrit.
C64799 Ery. Mean Corpuscular Ery. Mean Corpuscular Volume;Erythrocytes A measurement of the mean Erythrocyte Mean
Volume Mean Corpuscular Volume;RBC Mean Corpuscular cellular volume per erythrocyte in Corpuscular Volume
Volume a biological specimen.
C11119 Erythrocyte Agglutination Autoagglutination;Erythrocyte Agglutination;RBC A measurement of the erythrocyte Erythrocyte Agglutination
7 Agglutination agglutination in a biological Measurement
specimen.
C92245 Erythrocyte Cell Clumps Erythrocyte Cell Clumps;RBC Aggregates;RBC A measurement of red blood cell Erythrocyte Cell Clumps
Clumps;Red Blood Cell Clumps clumps in a biological specimen. Measurement
page 799 of 1925

C6715 LBTEST
4
Code Value
C92296 Erythrocyte Cell Erythrocyte Cell Morphology;RBC An examination or assessment of Erythrocyte Cell
Morphology Morphology;Red Blood Cell Morphology the form and structure of red Morphology
blood cells.
C11621 Erythrocyte Fragment Erythrocyte Fragment;RBC Fragment A measurement of the red blood Erythrocyte Fragment
2 cell fragments (red cell fragments Measurement
that have a reticular-like shape
with rounded ends and no
spicules, differentiating them from
schistocytes and acanthocytes) in
C96605 Erythrocyte Ghosts Erythrocyte Ghosts;RBC Ghosts A measurement of the erythrocyte Erythrocyte Ghost Count
ghosts (erythrocytes in which
hemoglobin has been removed
through hemolysis) in a biological
specimen.
C14733 Erythrocyte Erythrocyte Protoporphyrin, Free A measurement of the free Free Erythrocyte
9 Protoporphyrin, Free erythrocyte protoporphyrin (zinc Protoporphyrin
bound plus unbound Measurement
protoporphyrin) in a biological
specimen.
C74611 Erythrocyte Sedimentation Biernacki Reaction;Erythrocyte Sedimentation The distance (e.g. millimeters) Erythrocyte Sedimentation
Rate Rate that red blood cells settle in Rate Measurement
unclotted blood over a specified
unit of time (e.g. one hour).
C51946 Erythrocytes Erythrocytes;Red Blood Cells A measurement of the total Erythrocyte Count
specimen.
C64800 Erythrocytes Distribution Erythrocytes Distribution Width;RDW-CV;Red A relative measurement (ratio or Erythrocyte Distribution
Width Blood Cell Distribution Width;Red Cell Volume percentage) of the standard Width Measurement
Distribution Width deviation of the red blood cell
volume to the mean distribution of
the red blood cell volume in a
C15472 Erythroid Cells/Nucleated Erythroid Cells/Nucleated Cells A relative measurement (ratio or Erythroid Cells to
0 Cells percentage) of the erythroid cells Nucleated Cells Ratio
to total nucleated cells in a Measurement
C15471 Erythroid Cells/Total Cells Erythroid Cells/Total Cells A relative measurement (ratio or Erythroid Cells to Total
9 percentage) of the erythroid cells Cells Ratio Measurement
specimen.
C13541 Erythroid Maturation Index Erythroid Maturation Index A relative measurement (ratio) of Erythroid Maturation Index
5 the sum of erythroid maturation
phase cells (pool) to the sum of
erythroid proliferative phase cells
(pool) in a biological specimen.
C13541 Erythroid Maturation Pool Erythroid Maturation Pool A measurement of the erythroid Erythroid Maturation Pool
6 maturation phase cells Count
(polychromatic rubricytes,
normochromic rubricytes, and
metarubricytes) in a biological
specimen.
C13541 Erythroid Proliferation Erythroid Proliferation Index A relative measurement (ratio) of Erythroid Proliferation
7 Index the sum of erythroid proliferative Index
erythroid maturation phase cells
C13541 Erythroid Proliferation Pool Erythroid Proliferation Pool A measurement of the erythroid Erythroid Proliferation Pool
8 proliferative phase cells Count
(rubriblasts, prorubricytes, and
basophilic rubricytes) in a
C74855 Erythropoietin Erythropoietin;Hematopoietin A measurement of the Erythropoietin

erythropoietin hormone in a Measurement
C74782 Estradiol Estradiol;Oestradiol A measurement of the estradiol in Estradiol Measurement

C15084 Estradiol, Free Estradiol, Free A measurement of the unbound Free Estradiol
2 estradiol in a biological specimen. Measurement
page 800 of 1925

C6715 LBTEST
4
Code Value
C15084 Estradiol, Free/Estradiol Estradiol, Free/Estradiol A relative measurement (ratio or Free Estradiol to Estradiol
3 percentage) of unbound estradiol Ratio Measurement
to total estradiol in a biological
specimen.
C74856 Estriol Estriol;Oestriol A measurement of the estriol Estriol Measurement

C81963 Estriol, Free Estriol, Free;Unconjugated Estriol A measurement of the free estriol Free Estriol Measurement
C14733 Estrogen Estrogen;Oestrogen A measurement of the estrogen Estrogen Measurement

5 hormone in a biological specimen.
C11227 Estrogen Receptor ER;ESR;Estrogen Receptor;Oestrogen Receptor A measurement of estrogen Estrogen Receptor
4 receptor protein in a biological Measurement
specimen.
C74857 Estrone Estrone;Oestrone A measurement of the estrone Estrone Measurement

C74693 Ethanol Alcohol;Ethanol A measurement of the ethanol Ethanol Measurement

C10226 ETP Area Under Curve ETP Area Under Curve;Endogenous Thrombin A measurement of the area under Endogenous Thrombin
3 Potential Area Under Curve the thrombin generation curve. Potential Area Under
Curve Measurement
C10226 ETP Lag Time ETP Lag Time;Endogenous Thrombin Potential A measurement of time from the Endogenous Thrombin
4 Lag Time start of the thrombin generation Potential Lag Time
test to the point where a Measurement
predetermined amount of
thrombin is generated.
C10226 ETP Lag Time Relative ETP Lag Time Relative;Endogenous Thrombin A relative measurement (ratio or Endogenous Thrombin
5 Potential Lag Time Relative percentage) of time from the start Potential Lag Time
of the thrombin generation test to Relative Measurement
the point where a predetermined
amount of thrombin is generated.
C10226 ETP Peak Height ETP Peak Height;Endogenous Thrombin Potential A measurement of the maximum Endogenous Thrombin
7 Peak Height concentration of thrombin Potential Peak Height
generated during a thrombin Measurement
generation test.
C10226 ETP Peak Height Relative ETP Peak Height Relative;Endogenous Thrombin A relative (ratio or percentage) of Endogenous Thrombin
8 Potential Peak Height Relative the maximum concentration of Potential Peak Height
thrombin generated during a Relative Measurement
thrombin generation test.
C10226 ETP Time to Peak ETP Time to Peak;Endogenous Thrombin A measurement of the time it Endogenous Thrombin
9 Potential Time to Peak takes to generate the maximum Potential Time to Peak
concentration of thrombin. Measurement
C10227 ETP Time to Peak Relative ETP Time to Peak Relative;Endogenous Thrombin A relative (ratio or percentage) Endogenous Thrombin
0 Potential Time to Peak Relative measurement of the time it takes Potential Time to Peak
to generate the maximum Relative Measurement
concentration of thrombin.
C82011 Extracell Newly Ident Extracell Newly Ident RAGE Bind Protein;S100 A measurement of the Extracell Newly Ident
RAGE Bind Protein Calcium Binding Protein A12 extracellular newly identified RAGE RAGE Bind Protein
(receptor for advanced glycation Measurement
end products) binding protein in a
C92270 Extractable Nuclear Anti-ENA;Extractable Nuclear Antigen Antibody A measurement of the extractable Extractable Nuclear
Antigen Antibody nuclear antigen antibody in a Antigen Antibody
C80180 F2-Isoprostane F2-Isoprostane A measurement of the F2- F2 Isoprostane

isoprostane in a biological Measurement
specimen.
C96626 Factor II Factor II;Prothrombin A measurement of the coagulation Prothrombin Measurement

factor II in a biological specimen.
C81959 Factor III Factor III;Tissue Factor, CD142 A measurement of the coagulation Factor III Measurement
factor III in a biological specimen.
C98725 Factor IX Christmas Factor;Factor IX A measurement of the coagulation Factor IX Measurement

factor IX in a biological specimen.
page 801 of 1925

C6715 LBTEST
4
Code Value
C10339 Factor IX Activity Christmas Factor Activity;Factor IX Activity A measurement of the biological Factor IX Activity
5 activity of coagulation factor IX in Measurement
C98726 Factor V Factor V;Labile Factor A measurement of the coagulation Factor V Measurement
factor V in a biological specimen.
C10339 Factor V Activity Factor V Activity;Labile Factor Activity A measurement of the biological Factor V Activity
6 activity of coagulation factor V in a Measurement
C10227 Factor V Leiden Factor V Leiden A measurement of the coagulation Factor V Leiden
1 factor V Leiden in a biological Measurement
specimen.
C81960 Factor VII Factor VII;Proconvertin;Stable Factor A measurement of the coagulation Factor VII Measurement
factor VII in a biological specimen.
C10339 Factor VII Activity Factor VII Activity;Proconvertin Activity;Stable A measurement of the biological Factor VII Activity
7 Factor Activity activity of coagulation factor VII in Measurement
C10339 Factor VIIa Activity Factor VIIa Activity A measurement of the biological Factor VIIa Activity
8 activity of coagulation factor VIIa Measurement
C81961 Factor VIII Anti-hemophilic Factor;Factor VIII A measurement of the coagulation Factor VIII Measurement
factor VIII in a biological
specimen.
C10339 Factor VIII Activity Anti-hemophilic Factor Activity;Factor VIII A measurement of the biological Factor VIII Activity
9 Activity activity of coagulation factor VIII Measurement
C14734 Factor VIII Activity Factor VIII Activity Actual/Control;Factor VIII A relative measurement (ratio or Factor VIII Activity Actual
5 Actual/Control Activity Actual/Factor VIII Activity Control;Factor percentage) of the biological to Control Ratio
VIII Activity Actual/Normal activity of factor VIII dependent Measurement
coagulation in a subject's
specimen when compared to the
same activity in a control
specimen.
C15475 Factor VIII Inhibitor Factor VIII Inhibitor A measurement of the factor VIII Factor VIII Inhibitor
2 Inhibitor in a biological specimen. Measurement
C98727 Factor X Factor X A measurement of the coagulation Factor X Measurement

factor X in a biological specimen.
C12211 Factor X Activity Factor X Activity A measurement of the coagulation Factor X Activity
8 factor X activity in a biological Measurement
specimen.
C11227 Factor XIII Factor XIII;Fibrin Stabilizing Factor A measurement of the coagulation Factor XIII Measurement
7 factor XIII in a biological
specimen.
C10227 Factor XIV Autoprothrombin IIA;Factor XIV;Protein A measurement of the coagulation Factor XIV Measurement
2 C;Protein C Antigen factor XIV in a biological
specimen.
C10544 Factor XIV Activity Factor XIV Activity;Protein C Activity;Protein C A measurement of the coagulation Factor XIV Activity
2 Function factor XIV activity in a biological Measurement
specimen.
C14734 Factor XIV Activity Factor XIV Activity Actual/Control;Factor XIV A relative measurement (ratio or Factor XIV Activity Actual
6 Actual/Control Activity Actual/Factor XIV Activity Control;Factor percentage) of the biological to Control Ratio
XIV Activity Actual/Normal activity of factor XIV dependent Measurement
specimen.
C96648 Fat Fat A measurement of the fat in a Fat Measurement

C81947 Fat Bodies, Oval Fat Bodies, Oval A measurement of the oval- Oval Fat Body
shaped fat bodies, usually renal Measurement
proximal tubular cells with lipid
aggregates in the cytoplasm, in a
page 802 of 1925

C6715 LBTEST
4
Code Value
C98728 Fat Droplet Fat Droplet A measurement of the triglyceride Fat Droplet Measurement
aggregates within a biological
specimen.
C82012 Fatty Acid Binding Protein Fatty Acid Binding Protein 1 A measurement of the fatty acid Fatty Acid Binding Protein
1 binding protein 1 in a biological 1 Measurement
specimen.
C10652 Fatty Acid Binding Protein Fatty Acid Binding Protein 3 A measurement of the fatty acid Fatty Acid Binding Protein
1 3 binding protein 3 in a biological 3 Measurement
specimen.
C14733 Fatty Acids, Very Long Fatty Acids, Very Long Chain A measurement of the very long Very Long Chain Fatty
7 Chain chain fatty acids (containing 22 or Acids Measurement
more carbon atoms) in a biological
specimen.
C74766 Fatty Casts Fatty Casts A measurement of the fatty casts Fatty Cast Measurement
C14733 Fentanyl Fentanyl A measurement of the fentanyl in Fentanyl Measurement

C74737 Ferritin Ferritin A measurement of the ferritin in a Ferritin Measurement

C82013 Fibrin Degradation Fibrin Degradation Products A measurement of the fibrin Fibrin Degradation
Products degradation products in a Products Measurement
C64606 Fibrinogen Fibrinogen;Fibrinogen Antigen A measurement of the total Fibrinogen Measurement

fibrinogen (functional and non-
functional) in a biological
specimen.
C13907 Fibrinogen, Functional Fibrinogen, Functional A measurement of the functional Functional Fibrinogen
5 fibrinogen (fibrinogen that is Measurement
capable of being converted to
fibrin) in a biological specimen.
C15472 Fibroblast Growth Factor FGF 19;Fibroblast Growth Factor 19 A measurement of the fibroblast Fibroblast Growth Factor
7 19 growth factor 19 in a biological 19 Measurement
specimen.
C11228 Fibroblast Growth Factor FGF 21;Fibroblast Growth Factor 21 A measurement of the fibroblast Fibroblast Growth Factor
0 21 growth factor 21 in a biological 21 Measurement
specimen.
C96650 Fibroblast Growth Factor Fibroblast Growth Factor 23;Phosphatonin A measurement of the total Fibroblast Growth Factor
23 fibroblast growth factor 23 in a 23 Measurement
C13541 Fibroblast Growth Factor Fibroblast Growth Factor 23, C-Terminal A measurement of the C-terminal C-Terminal Fibroblast
9 23, C-Terminal fibroblast growth factor 23 in a Growth Factor 23
C13542 Fibroblast Growth Factor Fibroblast Growth Factor 23, Intact A measurement of the intact Intact Fibroblast Growth
0 23, Intact fibroblast growth factor 23 in a Factor 23 Measurement
C13016 Fibroblast Growth Factor 9 FGF 9;Fibroblast Growth Factor 9 A measurement of the fibroblast Fibroblast Growth Factor 9
2 growth factor 9 in a biological Measurement
specimen.
C82014 Fibroblast Growth Factor FGF2;Fibroblast Growth Factor Basic Form A measurement of the basic form Fibroblast Growth Factor
Basic Form of fibroblast growth factor in a Basic Form Measurement
C92786 Fibronectin, Fetal Fibronectin, Fetal A measurement of the fetal Fetal Fibronectin Test
isoform of fibronectin in a
biological specimen
C10544 FibroTest Score FibroSURE Score;FibroTest Score A biomarker test that measures FibroTest Score
3 liver pathology through the Measurement
assessment of a six-parameter
blood test (for Alpha-2-
macroglobulin, Haptoglobin,
Apolipoprotein A1, Gamma-
glutamyl transpeptidase (GGT),
Total bilirubin, and Alanine
aminotransferase (ALT)), taking
into account the age and gender of
the patient.
page 803 of 1925

C6715 LBTEST
4
Code Value
C13542 Flagellates Flagellates A measurement of the flagellates Flagellates Measurement

1 (protozoans that possess flagella)
C13908 Flunitrazepam Flunitrazepam A measurement of the Flunitrazepam

1 flunitrazepam present in a Measurement
C12212 Fluoride Fluoride A measurement of the fluoride in a Fluoride Measurement

C75373 Flurazepam Flurazepam A measurement of the flurazepam Flurazepam Measurement

C14734 Fluvoxamine Fluvoxamine A measurement of the Fluvoxamine Measurement

0 fluvoxamine present in a biological
specimen.
C13236 Folate Hydrolase mRNA Folate Hydrolase mRNA A measurement of the folate Folate Hydrolase mRNA
7 hydrolase mRNA in a biological Measurement
specimen.
C74783 Follicle Stimulating Follicle Stimulating Hormone A measurement of the follicle Follicle Stimulating
Hormone stimulating hormone (FSH) in a Hormone Measurement
C11421 Fractional Calcium Fractional Calcium Excretion A measurement of the fractional Fractional Excretion of
9 Excretion excretion of calcium that is Calcium
computed based upon the
concentrations of calcium and
creatinine in both blood and urine.
C11422 Fractional Chloride Fractional Chloride Excretion A measurement of the fractional Fractional Excretion of
0 Excretion excretion of chloride that is Chloride
concentrations of chloride and
C12211 Fractional Magnesium Fractional Magnesium Excretion A measurement of the fractional Fractional Excretion of
9 Excretion excretion of magnesium that is Magnesium
concentrations of magnesium and
C11422 Fractional Phosphorus Fractional Inorganic Phosphate A measurement of the fractional Fractional Excretion of
1 Excretion Excretion;Fractional Phosphorus Excretion excretion of phosphorus that is Phosphate
concentrations of phosphorus and
C11422 Fractional Potassium Fractional Potassium Excretion A measurement of the fractional Fractional Excretion of
2 Excretion excretion of potassium that is Potassium
concentrations of potassium and
C10743 Fractional Sodium Fractional Sodium Excretion A measurement of the fractional Fractional Excretion of
5 Excretion excretion of sodium that is Sodium
concentrations of sodium and
C12434 Free Androgen Index Free Androgen Index A measurement of the androgen Free Androgen Index
1 status in a biological specimen.
This is calculated by a
mathematical formula that takes
into account the total testosterone
level, sex hormone binding
globulin, and a constant.
C80200 Free Fatty Acid Free Fatty Acid;Non-Esterified Fatty Acid, Free A measurement of the total non- Non-esterified Fatty Acids
esterified fatty acids in a biological Measurement
specimen.
C80206 Free Fatty Acid, Saturated Free Fatty Acid, Saturated;Non-esterified Fatty A measurement of the saturated Saturated Non-esterified
Acid, Saturated non-esterified fatty acids in a Fatty Acids Measurement
C80209 Free Fatty Acid, Free Fatty Acid, Unsaturated;Non-esterified Fatty A measurement of the unsaturated Unsaturated Non-esterified
Unsaturated Acid, Unsaturated non-esterified fatty acids in a Fatty Acids Measurement
page 804 of 1925

C6715 LBTEST
4
Code Value
C10044 Free Glycerol Free Glycerin;Free Glycerol A measurement of the amount of Free Glycerol
8 unbound glycerol in a biological Measurement
specimen.
C74678 Fructosamine Fructosamine;Glycated Serum Protein A measurement of the Fructosamine

fructosamine in a biological Measurement
specimen.
C14734 Fructose Fructose A measurement of the fructose in Fructose Measurement

C14734 Fungi, Filamentous Fungi, Filamentous A measurement of the filamentous Filamentous Fungi Count
3 fungi in a biological specimen.
C14734 Fungi, Yeast-Like Fungi, Yeast-Like A measurement of the yeast-like Yeast-Like Fungi Count
4 fungi in a biological specimen.
C13236 G6PD-Deficient G6PD-Deficient Erythrocytes A measurement of the glucose-6- G6PD-Deficient

8 Erythrocytes phosphate dehydrogenase Erythrocytes Count
deficient erythrocytes in a
C13236 G6PD-Deficient G6PD-Deficient Erythrocytes/Erythrocytes A relative measurement (ratio or G6PD-Deficient

9 Erythrocytes/Erythrocytes percentage) of G6PD-deficient Erythrocytes to
erythrocytes to total erythrocytes Erythrocytes Ratio
C12434 Galactose Elimination Galactose Elimination Capacity A liver function test that measures Galactose Elimination
2 Capacity galactose elimination capacity in a Capacity
C80182 Galanin Galanin A measurement of the galanin in a Galanin Measurement

C92257 Gamma Globulin Gamma Globulin A measurement of the proteins Gamma Globulin
contributing to the gamma fraction Measurement
C92295 Gamma Globulin/Total Gamma Globulin/Total Protein A relative measurement (ratio or Gamma Globulin to Total
Protein percentage) of gamma fraction Protein Ratio Measurement
C64847 Gamma Glutamyl Gamma Glutamyl Transferase A measurement of the gamma Gamma Glutamyl
Transferase glutamyl transferase in a biological Transpeptidase
C79446 Gamma Glutamyl Gamma Glutamyl Transferase/Creatinine A relative measurement (ratio or Gamma Glutamyl
Transferase/Creatinine percentage) of the gamma Transferase to Creatinine
glutamyl transferase to creatinine Ratio Measurement
C11621 Gamma Tocopherol Gamma Tocopherol A measurement of the gamma Gamma Tocopherol
1 tocopherol in a biological Measurement
specimen.
C15476 Gamma-Aminobutyric Acid GABA;Gamma-Aminobutyric Acid;Gamma- A measurement of the gamma- Gamma-Aminobutyric Acid
6 aminobutyrate aminobutyric acid in a biological Measurement
specimen.
C74858 Gastrin Gastrin A measurement of the gastrin Gastrin Measurement

C13014 German Cockroach German Cockroach Antigen IgA Antibody A measurement of the Blattella German Cockroach
1 Antigen IgA Antibody germanica antigen IgA antibody in Antigen IgA Antibody
C13014 German Cockroach German Cockroach Antigen IgE Antibody A measurement of the Blattella German Cockroach
0 Antigen IgE Antibody germanica antigen IgE antibody in Antigen IgE Antibody
C13014 German Cockroach German Cockroach Antigen IgG Antibody A measurement of the Blattella German Cockroach
2 Antigen IgG Antibody germanica antigen IgG antibody in Antigen IgG Antibody
C13014 German Cockroach German Cockroach Antigen IgG4 Antibody A measurement of the Blattella German Cockroach
3 Antigen IgG4 Antibody germanica antigen IgG4 antibody Antigen IgG4 Antibody
page 805 of 1925

C6715 LBTEST
4
Code Value
C10045 GFR from B-2 GFR from B-2 Microglobulin Adj for BSA A measurement of the glomerular Glomerular Filtration Rate
0 Microglobulin Adj for BSA filtration rate (GFR) based on the from B-2 Microglobulin
clearance of beta-2 microglobulin Adjusted for BSA
after adjusting it for the body Measurement
surface area.
C10044 GFR from Beta-Trace GFR from Beta-Trace Protein Adj for BSA A measurement of the glomerular Glomerular Filtration Rate
9 Protein Adj for BSA filtration rate (GFR) based on the from Beta-Trace Protein
clearance of beta-trace protein Adjusted for BSA
after adjusting it for the body Measurement
surface area.
C98735 GFR from Creatinine GFR from Creatinine Adjusted for BSA An estimation of the glomerular Glomerular Filtration Rate
Adjusted for BSA filtration rate adjusted for body from Creatinine Adjusted
surface area based on creatinine. for BSA
C98736 GFR from Cystatin C GFR from Cystatin C Adjusted for BSA An estimation of the glomerular Glomerular Filtration Rate
Adjusted for BSA filtration rate adjusted for body from Cystatin C Adjusted
surface area based on cystatin C. for BSA
C12761 GFR from Cystatin C and GFR from Cystatin C and Creat Adj BSA An estimation of the glomerular Glomeluar Filtration Rate
4 Creat Adj BSA filtration rate adjusted for body from Cystatin C and
surface area based on cystatin C Creatinine Adjusted for
and creatinine. BSA
C11228 Ghrelin Ghrelin;Growth Hormone Secretagogue Receptor A measurement of total ghrelin in Ghrelin Measurement
6 Ligand;Motilin-related Peptide;Total Ghrelin a biological specimen.
C96651 Giant Neutrophils Giant Neutrophils A measurement of the giant Giant Neutrophil Count
neutrophils in a biological
specimen.
C74728 Giant Platelets Giant Platelets A measurement of the giant Giant Platelet Count
(larger than 7um in diameter)
platelets in a biological specimen.
C14734 Gliadin Antibody Gliadin Antibody A measurement of the total gliadin Gliadin Antibody
specimen.
C14734 Gliadin IgA Antibody Gliadin IgA Antibody A measurement of the gliadin IgA Gliadin IgA Antibody
C14734 Gliadin IgG Antibody Gliadin IgG Antibody A measurement of the gliadin IgG Gliadin IgG Antibody
C15084 Glitter Cells Glitter Cells A measurement of the glitter cells Glitter Cell Count
C74738 Globulin Globulin A measurement of the globulin Globulin Protein

C14227 Globulin/Creatinine Globulin/Creatinine A relative measurement (ratio or Globulin to Creatinine

6 percentage) of the globulin to Ratio Measurement
C90505 Glomerular Filtration Rate Glomerular Filtration Rate A kidney function test that Glomerular Filtration Rate
measures the fluid volume that is
filtered from the kidney glomeruli
to the Bowman's capsule per unit
of time.
C98734 Glomerular Filtration Rate Glomerular Filtration Rate Adj for BSA A measurement of the glomerular Glomerular Filtration Rate
Adj for BSA filtration rate adjusted for body Adjusted for BSA
surface area.
C11093 Glomerular Filtration Rate, Glomerular Filtration Rate, Estimated A kidney function test that Estimated Glomerular
5 Estimated estimates the fluid volume that is Filtration Rate
filtered from the kidney glomeruli
to the Bowman's capsule per unit
of time.
C74859 Glucagon Glucagon A measurement of the glucagon Glucagon Measurement

C80183 Glucagon-Like Peptide-1 Glucagon-Like Peptide-1;Total Glucagon-Like A measurement of the total Glucagon-like Peptide-1
Peptide-1 glucagon-like peptide-1 in a Measurement
C80164 Glucagon-Like Peptide-1, Glucagon-Like Peptide-1, Active Form A measurement of the active form Active Glucagon-like
Active Form of glucagon-like peptide-1 in a Peptide-1 Measurement
page 806 of 1925

C6715 LBTEST
4
Code Value
C15476 Glucagon-Like Peptide-1, Glucagon-Like Peptide-1, Inactive Form A measurement of the inactive Inactive Glucagon-Like
8 Inactive Form form of glucagon-like peptide-1 in Peptide-1 Measurement
C10558 Glucose Glucose A measurement of the glucose in a Glucose Measurement

C96652 Glucose Clearance Glucose Clearance A measurement of the volume of Glucose Clearance
serum or plasma that would be Measurement
cleared of glucose by excretion of
(e.g. one minute).
C15081 Glucose Excretion Rate Glucose Excretion Rate A measurement of the amount of Glucose Excretion Rate
8 glucose being excreted in a
C14735 Glucose, Estimated EAG;Estimated Average Glucose;Glucose, An estimated average of the Estimated Glucose
0 Estimated glucose in a biological specimen. Measurement
This estimate is calculated based
on glycated hemoglobin
concentrations.
C14227 Glucose, Estimated Glucose, Estimated Average A computed estimate of the blood Estimated Average
5 Average glucose based on the value of the Glucose
glycated hemoglobin
C80184 Glucose-6-Phosphate Glucose-6-Phosphate Dehydrogenase A measurement of the glucose-6- Glucose-6-Phosphate

Dehydrogenase phosphate dehydrogenase in a Dehydrogenase
C13906 Glucose-6-Phosphate Glucose-6-Phosphate Dehydrogenase Act A measurement of the biological Glucose-6-Phosphate

5 Dehydrogenase Act activity of glucose-6-phosphate Dehydrogenase Activity
dehydrogenase in a biological
specimen.
C10653 Glucose-dep Insulinotropic Glucose-dep Insulinotropic Pep, Intact;Intact A measurement of the intact Intact Glucose-dependent
7 Pep, Intact GIP;Intact Gastric Inhibitory Polypeptide;Intact (containing amino acids 1-42) Insulinotropic Peptide
Glucose-dependent Insulinotropic Peptide glucose-dependent insulinotropic Measurement
peptide in a biological specimen.
C79447 Glucose/Creatinine Glucose/Creatinine A relative measurement (ratio or Glucose to Creatinine

percentage) of the glucose to Ratio Measurement
C80165 Glucuronidase, Alpha Glucuronidase, Alpha A measurement of the alpha Alpha Glucuronidase
glucuronidase in a biological Measurement
specimen.
C80170 Glucuronidase, Beta Glucuronidase, Beta A measurement of the beta Beta Glucuronidase
glucuronidase in a biological Measurement
specimen.
C74739 Glutamate Glutamate;Glutamic Acid A measurement of the glutamate Glutamate Measurement

C79448 Glutamate Dehydrogenase Glutamate Dehydrogenase A measurement of the glutamate Glutamate Dehydrogenase
dehydrogenase in a biological Measurement
specimen.
C82015 Glutamic Acid Glutamic Acid Decarboxylase 1;Glutamic Acid A measurement of the glutamic Glutamic Acid
Decarboxylase 1 Decarboxylase 67 acid decarboxylase 1 in a Decarboxylase 1
C82016 Glutamic Acid Glutamic Acid Decarboxylase 2;Glutamic Acid A measurement of the glutamic Glutamic Acid
Decarboxylase 2 Decarboxylase 65 acid decarboxylase 2 in a Decarboxylase 2
C82017 Glutamic Acid Glutamic Acid Decarboxylase 2 A measurement of the glutamic Glutamic Acid
Decarboxylase 2 Antibody Antibody;Glutamic Acid Decarboxylase 65 acid decarboxylase 2 antibody in a Decarboxylase 2 Antibody
Antibody biological specimen. Measurement
C96653 Glutamic Acid GAD Antibody;Glutamic Acid Decarboxylase A measurement of the glutamic Glutamic Acid
Decarboxylase Antibody Antibody acid decarboxylase antibody in a Decarboxylase Antibody
C12212 Glutamine Glutamine A measurement of the glutamine Glutamine Measurement

page 807 of 1925

C6715 LBTEST
4
Code Value
C80166 Glutathione S-Transferase, Glutathione S-Transferase, Alpha/Creat A relative measurement (ratio or Alpha Glutathione-S-
Alpha/Creat percentage) of the alpha Transferase to Creatinine
glutathione-S-transferase to Ratio Measurement
C80203 Glutathione S-Transferase, Glutathione S-Transferase, Pi A measurement of the Pi Pi Glutathione S-

Pi glutathione-s-transferase in a Transferase Measurement
C80207 Glutathione S-Transferase, Glutathione S-Transferase, Theta A measurement of the theta Theta Glutathione S-
Theta glutathione-s-transferase in a Transferase Measurement
C80185 Glutathione S-Transferase, Glutathione S-Transferase, Total A measurement of the total Glutathione-S-Transferase
Total glutathione-s-transferase in a Measurement
C79435 Glutathione-S- Glutathione-S-Transferase/Creatinine A relative measurement (ratio or Glutathione-S-Transferase

Transferase/Creatinine percentage) of the glutathione S- to Creatinine Ratio
transferase to creatinine in a Measurement
C12209 Glycated Albumin Glycated Albumin A measurement of the glycated Glycated Albumin
2 albumin present in a biological Measurement
specimen.
C13237 Glycerol Glycerol A measurement of the total Glycerol Measurement

1 glycerol in a biological specimen.
C12212 Glycine Glycine A measurement of the glycine in a Glycine Measurement

C14727 Glycine max Antigen IgE Glycine max Antigen IgE Antibody;Soybean A measurement of the Glycine Glycine max Antigen IgE
8 Antibody Antigen IgE Antibody max antigen IgE antibody in a Antibody Measurement
C80186 Gold Gold A measurement of the gold in a Gold Measurement

C74860 Gonadotropin Releasing Gonadotropin Releasing Hormone;Luteinising A measurement of the Gonadotropin Releasing
Hormone Hormone Releasing Hormone gonadotropin releasing hormone in Hormone Measurement
C74768 Granular Casts Granular Casts A measurement of the granular Granular Cast
(coarse and fine) casts present in Measurement
C74765 Granular Coarse Casts Granular Coarse Casts A measurement of the coarse Coarse Granular Cast
granular casts present in a Measurement
C74769 Granular Fine Casts Granular Fine Casts A measurement of the fine Granular Fine Cast
granular casts present in a Measurement
C82018 Granulocyte Colony Granulocyte Colony Stimulating Factor A measurement of the granulocyte Granulocyte Colony
Stimulating Factor colony stimulating factor in a Stimulating Factor
C82019 Granulocyte Macrophage Granulocyte Macrophage Colony Stm Factor A measurement of the granulocyte Granulocyte Macrophage
Colony Stm Factor macrophage colony stimulating Colony Stm Factor
factor in a biological specimen. Measurement
C96654 Granulocytes Granulocytes;Polymorphonuclear Leukocytes A measurement of the Granulocyte Count

granulocytes in a biological
specimen.
C12761 Granulocytes Band Granulocytes Band Form/Total Cells A relative measurement (ratio or Band Form Granulocyte to
5 Form/Total Cells percentage) of the banded Total Cell Ratio
granulocytes to total cells in a Measurement
C12761 Granulocytes Granulocytes Segmented/Total Cells A relative measurement (ratio or Segmented Granulocyte to
6 Segmented/Total Cells percentage) of the segmented Total Cell Ratio
granulocytes to total cells in a Measurement
C14735 Granulocytes/Leukocytes Granulocytes/Leukocytes;Polymorphonuclear A relative measurement (ratio or Granulocytes to

1 Leukocytes/Leukocytes percentage) of the granulocytes to Leukocytes Ratio
total leukocytes in a biological Measurement
specimen.
page 808 of 1925

C6715 LBTEST
4
Code Value
C98866 Granulocytes/Total Cells Granulocytes/Total Cells A relative measurement (ratio or Granulocyte to Total Cell
percentage) of the granulocytes to Ratio Measurement
specimen).
C13010 Grass Mix Pollen Antigen Grass Mix Pollen Antigen IgA Antibody A measurement of the grass mix Grass Mix Pollen Antigen
5 IgA Antibody pollen antigen IgA antibody in a IgA Antibody
C13010 Grass Mix Pollen Antigen Grass Mix Pollen Antigen IgE Antibody A measurement of the grass mix Grass Mix Pollen Antigen
3 IgE Antibody pollen antigen IgE antibody in a IgE Antibody Measurement
C13010 Grass Mix Pollen Antigen Grass Mix Pollen Antigen IgG Antibody A measurement of the grass mix Grass Mix Pollen Antigen
4 IgG Antibody pollen antigen IgG antibody in a IgG Antibody
C13542 Growth Differentiation BMP-11;Bone Morphogenetic Protein 11;Growth A measurement of the growth Growth Differentiation
2 Factor 11 Differentiation Factor 11 differentiation factor 11 in a Factor 11 Measurement
C13542 Growth Differentiation Growth Differentiation Factor 8;Myostatin A measurement of the growth Growth Differentiation
3 Factor 8 differentiation factor 8 in a Factor 8 Measurement
C74861 Growth Hormone Inhibiting Growth Hormone Inhibiting A measurement of the growth Growth Hormone
Hormone Hormone;Somatostatin hormone inhibiting hormone in a Inhibiting Hormone
C74862 Growth Hormone Growth Hormone Releasing A measurement of the growth Growth Hormone
Releasing Hormone Hormone;Somatocrinin hormone releasing hormone in a Releasing Hormone
C15084 Guanine Deaminase Guanase;Guanine Aminohydrolase;Guanine A measurement of the guanine Guanine Deaminase
5 Deaminase deaminase in a biological Measurement
specimen.
C74604 Hairy Cells Hairy Cells A measurement of the hairy cells Hairy Cell Count
(b-cell lymphocytes with hairy
projections from the cytoplasm) in
C13542 Hairy Cells/Leukocytes Hairy Cells/Leukocytes A relative measurement (ratio or Hairy Cells to Leukocytes
8 percentage) of the hairy cells (B- Ratio Measurement
cell lymphocytes with hairy
projections from the cytoplasm) to
all leukocytes in a biological
specimen.
C74640 Hairy Cells/Lymphocytes Hairy Cells/Lymphocytes A relative measurement (ratio or Hairy Cell to Lymphocyte
percentage) of the hairy cells (b- Ratio Measurement
cell lymphocytes with hairy
projections from the cytoplasm) to
all lymphocytes in a biological
specimen .
C13542 Hairy Cells/Total Cells Hairy Cells/Total Cells A relative measurement (ratio or Hairy Cells to Total Cells
7 percentage) of the hairy cells to Ratio Measurement
C13907 Halazepam Halazepam A measurement of the halazepam Halazepam Measurement

C74740 Haptoglobin Haptoglobin A measurement of the haptoglobin Haptoglobin Protein

C10227 HCT Corrected HCT Corrected Reticulocytes/Erythrocytes A relative measurement (ratio or Hematocrit Corrected
4 Reticulocytes/Erythrocytes percentage) of the hematocrit Reticulocytes to
corrected reticulocytes to Erythrocytes Ratio
erythrocytes in a biological Measurement
specimen.
C13908 HCV Antibody Signal/HCV HCV Antibody Signal/HCV Antibody Cutoff A relative measurement (ratio) of HCV Antibody Signal to
6 Antibody Cutoff the Hepatitis C virus antibody HCV Antibody Cutoff Ratio
signal in a biological specimen to Measurement
Hepatitis C virus positive internal
control.
C10558 HDL Cholesterol HDL Cholesterol A measurement of the high High Density Lipoprotein
7 density lipoprotein cholesterol in a Cholesterol Measurement
page 809 of 1925

C6715 LBTEST
4
Code Value
C10042 HDL Cholesterol/LDL HDL Cholesterol/LDL Cholesterol A relative measurement (ratio or HDL Cholesterol to LDL
5 Cholesterol percentage) of the amount of HDL Cholesterol Ratio
cholesterol compared to LDL Measurement
cholesterol in a biological
specimen.
C14736 HDL Cholesterol/Total HDL Cholesterol/Total Cholesterol A relative measurement (ratio or HDL Cholesterol to Total
2 Cholesterol percentage) of the amount of HDL Cholesterol Ratio
cholesterol compared to total Measurement
cholesterol in a biological
specimen.
C10340 HDL Particle Size HDL Particle Size A measurement of the average HDL Particle Size
2 particle size of high-density Measurement
lipoprotein in a biological
specimen.
C80187 HDL-Cholesterol Subclass HDL-Cholesterol Subclass 2 A measurement of the high- HDL-Cholesterol Subclass
2 density lipoprotein (HDL) 2 Measurement
cholesterol subclass 2 in a
C80188 HDL-Cholesterol Subclass HDL-Cholesterol Subclass 3 A measurement of the high- HDL-Cholesterol Subclass
3 density lipoprotein (HDL) 3 Measurement
cholesterol subclass 3 in a
C14736 Heat Shock Protein 70 Heat Shock Protein 70 A measurement of the heat shock Heat Shock Protein 70
8 protein 70 in a biological Measurement
specimen.
C14736 Heat Shock Protein 90 Heat Shock Protein 90 Alpha A measurement of the heat shock Heat Shock Protein 90
9 Alpha protein 90 alpha in a biological Alpha Measurement
specimen.
C74709 Heinz Bodies Heinz Bodies;Heinz-Erhlich Bodies A measurement of the Heinz Heinz-Ehrlich Body
bodies (small round inclusions Measurement
within the body of a red blood cell)
C11120 Heinz Bodies/Erythrocytes Heinz Bodies/Erythrocytes A relative measurement (ratio or Heinz Body to Erythrocyte
6 percentage) of the erythrocytes Ratio Measurement
that contain heinz bodies to total
specimen.
C10340 Helicobacter pylori IgG Helicobacter pylori IgG Antibody A measurement of the Helicobacter pylori IgG
3 Antibody Helicobacter pylori IgG antibody in Antibody Measurement
C74658 Helmet Cells Helmet Cells A measurement of the Helmet Helmet Cell Count
cells (specialized Keratocytes with
two projections on either end that
are tapered and hornlike) in a
C64796 Hematocrit EVF;Erythrocyte Volume The percentage of a whole blood Hematocrit Measurement
Fraction;Hematocrit;PCV;Packed Cell Volume specimen that is composed of red
blood cells (erythrocytes).
C10227 Hematocrit Corrected Hematocrit Corrected Reticulocytes A measurement of the hematocrit Hematocrit Corrected
3 Reticulocytes corrected reticulocytes in a Reticulocyte Count
C64848 Hemoglobin Hemoglobin;Hemoglobin Monomer A measurement of the total Hemoglobin Measurement

erythrocyte associated hemoglobin
C92258 Hemoglobin A Hemoglobin A A measurement of the hemoglobin Hemoglobin A

A in a biological specimen. Measurement
C81276 Hemoglobin A/Total Hemoglobin A/Total Hemoglobin A relative measurement (ratio or Hemoglobin A to Total
Hemoglobin percentage) of the hemoglobin A Hemoglobin Ratio
to total hemoglobin in a biological Measurement
specimen.
C14736 Hemoglobin A1/Total Hemoglobin A1/Total Hemoglobin A relative measurement (ratio or Hemoglobin A1 to Total
3 Hemoglobin percentage) of the hemoglobin A1 Hemoglobin Ratio
specimen.
page 810 of 1925

C6715 LBTEST
4
Code Value
C64849 Hemoglobin A1C Glycosylated Hemoglobin;Hemoglobin A1C A measurement of the Glycosylated Hemoglobin
glycosylated hemoglobin in a Measurement
C11120 Hemoglobin Hemoglobin A1C/Hemoglobin A relative measurement (ratio or Hemoglobin A1C to

7 A1C/Hemoglobin percentage) of the glycosylated Hemoglobin Ratio
hemoglobin to total hemoglobin in Measurement
C92259 Hemoglobin A2 Hemoglobin A2 A measurement of the hemoglobin Hemoglobin A2

A2 in a biological specimen. Measurement
C14735 Hemoglobin A2 Hemoglobin A2 Prime/Total Hemoglobin A relative measurement (ratio or Hemoglobin A2 Prime to
3 Prime/Total Hemoglobin percentage) of the hemoglobin A2 Total Hemoglobin Ratio
prime to total hemoglobin in a Measurement
C81277 Hemoglobin A2/Total Hemoglobin A2/Total Hemoglobin A relative measurement (ratio or Hemoglobin A2 to Total
Hemoglobin percentage) of the hemoglobin A2 Hemoglobin Ratio
specimen.
C92260 Hemoglobin B Hemoglobin B A measurement of the hemoglobin Hemoglobin B

B in a biological specimen. Measurement
C14735 Hemoglobin Barts/Total Hemoglobin Barts/Total Hemoglobin A relative measurement (ratio or Hemoglobin Barts to Total
4 Hemoglobin percentage) of the hemoglobin Hemoglobin Ratio
Barts to total hemoglobin in a Measurement
C92261 Hemoglobin C Hemoglobin C A measurement of the hemoglobin Hemoglobin C

C in a biological specimen. Measurement
C11228 Hemoglobin C Crystals Hemoglobin C Crystals A measurement of hemoglobin C Hemoglobin C Crystals

8 crystals in a biological specimen. Measurement
C81278 Hemoglobin C/Total Hemoglobin C/Total Hemoglobin A relative measurement (ratio or Hemoglobin C to Total
Hemoglobin percentage) of the hemoglobin C Hemoglobin Ratio
specimen.
C14736 Hemoglobin D/Total Hemoglobin D/Total Hemoglobin A relative measurement (ratio or Hemoglobin D to Total
4 Hemoglobin percentage) of the hemoglobin D Hemoglobin Ratio
specimen.
C10652 Hemoglobin Distribution Hemoglobin Concentration Distribution A measurement of the distribution Hemoglobin Distribution
5 Width Width;Hemoglobin Distribution Width of the hemoglobin concentration in Width Measurement
red blood cells.
C14736 Hemoglobin E/Total Hemoglobin E/Total Hemoglobin A relative measurement (ratio or Hemoglobin E to Total
5 Hemoglobin percentage) of the hemoglobin E Hemoglobin Ratio
specimen.
C92262 Hemoglobin F Fetal Hemoglobin;Hemoglobin F A measurement of the hemoglobin Hemoglobin F

F in a biological specimen. Measurement
C14736 Hemoglobin F/Total Hemoglobin F/Total Hemoglobin A relative measurement (ratio or Hemoglobin F to Total
6 Hemoglobin percentage) of the fetal Hemoglobin Ratio
hemoglobin (hemoglobin F) to Measurement
total hemoglobin in a biological
specimen.
C14735 Hemoglobin G Hemoglobin G Coushatta/Total Hemoglobin A relative measurement (ratio or Hemoglobin G Coushatta
6 Coushatta/Total percentage) of the hemoglobin G to Total Hemoglobin Ratio
Hemoglobin Coushatta to total hemoglobin in a Measurement
C14735 Hemoglobin Lepore/Total Hemoglobin Lepore/Total Hemoglobin A relative measurement (ratio or Hemoglobin Lepore to
7 Hemoglobin percentage) of the Lepore Total Hemoglobin Ratio
hemoglobin to total hemoglobin in Measurement
C14735 Hemoglobin O-Arab/Total Hemoglobin O-Arab/Total Hemoglobin A relative measurement (ratio or Hemoglobin O-Arab to
8 Hemoglobin percentage) of the hemoglobin O- Total Hemoglobin Ratio
Arab to total hemoglobin in a Measurement
C12212 Hemoglobin S Hemoglobin S;Sickle Hemoglobin A measurement of the hemoglobin Hemoglobin S

3 S in a biological specimen. Measurement
page 811 of 1925

C6715 LBTEST
4
Code Value
C81279 Hemoglobin S/Total Hemoglobin S/Total Hemoglobin A relative measurement (ratio or Hemoglobin S to Total
Hemoglobin percentage) of the hemoglobin S Hemoglobin Ratio
specimen.
C13542 Hemoglobin Tetramer Hemoglobin Tetramer A measurement of the hemoglobin Hemoglobin Tetramer
5 tetramer in a biological specimen. Measurement
C12761 Hemoglobin, Free Hemoglobin, Free A measurement of the hemoglobin Free Hemoglobin
7 external to erythrocytes in a Measurement
C11120 Hemolytic Index Hemolysis;Hemolytic Index A measurement of the destruction Hemolytic Index
8 of red blood cells in a biological
specimen.
C96659 Hemosiderin Hemosiderin A measurement of the Hemosiderin Measurement

hemosiderin complex in a
C92534 Hepatitis A Virus Antibody Hepatitis A Virus Antibody A measurement of the hepatitis A Hepatitis A Antibody
virus antibody in a biological Measurement
specimen.
C92271 Hepatitis A Virus IgM Hepatitis A Virus IgM Antibody A measurement of hepatitis A Hepatitis A Virus Antibody
Antibody virus IgM antibody in a biological IgM Measurement
specimen.
C12594 Hepatitis B Virus Antibody Hepatitis B Virus Antibody A measurement of an unspecified Hepatitis B Virus Antibody
4 hepatitis B antibody in a biological Measurement
specimen.
C96660 Hepatitis B Virus Core Hepatitis B Virus Core Antibody A measurement of the hepatitis B Hepatitis B Virus Core
Antibody virus core antibody in a biological Antibody Measurement
specimen.
C11928 Hepatitis B Virus Core IgG Hepatitis B Virus Core IgG Antibody A measurement of the hepatitis B Hepatitis B Virus Core IgG
0 Antibody virus core IgG antibody in a Antibody Measurement
C96661 Hepatitis B Virus Core IgM Hepatitis B Virus Core IgM Antibody A measurement of the hepatitis B Hepatitis B Virus Core IgM
Antibody virus core IgM antibody in a Antibody Measurement
C96662 Hepatitis B Virus e Hepatitis B Virus e Antibody A measurement of the hepatitis B Hepatitis B Virus e
Antibody e antibody in a biological Antibody Measurement
specimen.
C96663 Hepatitis B Virus e Antigen Hepatitis B Virus e Antigen A measurement of the hepatitis B Hepatitis B Virus e Antigen
e antigen in a biological specimen. Measurement
C74711 Hepatitis B Virus Surface Anti-HBs;HBsAb;Hepatitis B Virus Surface A measurement of the hepatitis B Hepatitis B Surface
Antibody Antibody virus surface antibody in a Antibody Measurement
C64850 Hepatitis B Virus Surface HBsAg;Hepatitis B Virus Surface Antigen A measurement of the surface Hepatitis B Virus Surface
Antigen antigen reaction of a biological Antigen Measurement
specimen to the Hepatitis B virus.
C92535 Hepatitis C Virus Antibody Hepatitis C Virus Antibody A measurement of the hepatitis C Hepatitis C Antibody
virus antibody in a biological Measurement
specimen.
C11619 Hepatitis C Virus Antigen Hepatitis C Virus Antigen A measurement of the hepatitis C Hepatitis C Virus Antigen
6 virus antigen in a biological Measurement
specimen.
C13542 Hepatitis C Virus Core Hepatitis C Virus Core Antigen A measurement of the hepatitis C Hepatitis C Virus Core
4 Antigen virus core antigen in a biological Antigen Measurement
specimen.
C96664 Hepatitis D Virus Antibody Hepatitis D Virus Antibody;Hepatitis Delta A measurement of the hepatitis D Hepatitis D Virus Antibody
Antibody virus antibody in a biological Measurement
specimen.
C11928 Hepatitis D Virus IgG Hepatitis D Virus IgG Antibody A measurement of the hepatitis D Hepatitis D Virus IgG
1 Antibody virus IgG antibody in a biological Antibody Measurement
specimen.
C11928 Hepatitis D Virus IgM Hepatitis D Virus IgM Antibody A measurement of the hepatitis D Hepatitis D Virus IgM
2 Antibody virus IgM antibody in a biological Antibody Measurement
specimen.
page 812 of 1925

C6715 LBTEST
4
Code Value
C11928 Hepatitis E Virus Antibody Hepatitis E Virus Antibody A measurement of the hepatitis E Hepatitis E Virus Antibody
3 virus antibody in a biological Measurement
specimen.
C10652 Hepatitis E Virus IgG Hepatitis E Virus IgG Antibody A measurement of IgG antibody to Hepatitis E Virus IgG
6 Antibody the hepatitis E virus in a biological Antibody Measurement
specimen.
C96665 Hepatitis E Virus IgM Hepatitis E Virus IgM Antibody A measurement of the hepatitis E Hepatitis E Virus IgM
Antibody virus IgM antibody in a biological Antibody Measurement
specimen.
C13542 Hepatocyte Growth Factor Hepatocyte Growth Factor A measurement of the hepatocyte Hepatocyte Growth Factor
6 growth factor in a biological Measurement
specimen.
C11229 HER2 Antigen HER2 Antigen;HER2/NEU Antigen A measurement of the HER2 HER2 Antigen
1 antigen in a biological specimen. Measurement
C96666 Herpes Simplex Virus 1 HSV-1 IgG Antibody;Herpes Simplex Virus 1 IgG A measurement of the herpes Herpes Simplex Virus 1
IgG Antibody Antibody simplex virus 1 IgG antibody in a IgG Antibody
C98738 Herpes Simplex Virus 1 Herpes Simplex Virus 1 IgM Antibody A measurement of the Herpes Herpes Simplex Virus 1
IgM Antibody Simplex virus 1 IgM antibodies in IgM Antibody
C96697 Herpes Simplex Virus 1/2 HSV-1/2 IgG Ab;Herpes Simplex Virus 1/2 IgG A measurement of the herpes Herpes Simplex Virus 1/2
IgG Antibody Antibody simplex virus 1 and 2 IgG antibody IgG Antibody
C96698 Herpes Simplex Virus 1/2 HSV-1/2 IgM Ab;Herpes Simplex Virus 1/2 IgM A measurement of the herpes Herpes Simplex Virus 1/2
IgM Antibody Antibody simplex virus 1 and 2 IgM IgM Antibody
C96667 Herpes Simplex Virus 2 HSV-2 IgG Antibody;Herpes Simplex Virus 2 IgG A measurement of the herpes Herpes Simplex Virus 2
IgG Antibody Antibody simplex virus 2 IgG antibody in a IgG Antibody
C98739 Herpes Simplex Virus 2 Herpes Simplex Virus 2 IgM Antibody A measurement of the Herpes Herpes Simplex Virus 2
IgM Antibody Simplex virus 2 IgM antibodies in IgM Antibody
C11229 Herpes Simplex Virus 6 Herpes Simplex Virus 6 Antibody A measurement of the herpes Herpes Simplex Virus 6
2 Antibody simplex virus 6 antibody in a Antibody Measurement
C81984 Heterophile Antibodies Heterophile Antibodies A measurement of the heterophile Heterophile Antibody
specimen.
C11618 Heterophils Heterophils A measurement of heterophils Heterophil Measurement

6 (granular leukocytes) in a
biological specimen from avian
species.
C11618 Heterophils/Leukocytes Heterophils/Leukocytes A relative measurement (ratio or Heterophils to Leukocytes

7 percentage) of heterophils to Ratio Measurement
leukocytes in a biological specimen
from avian species.
C96668 Hexokinase Hexokinase A measurement of the hexokinase Hexokinase Measurement

C11618 High Absorption High Absorption Retic/Reticulocytes A relative measurement (ratio or High Absorption
9 Retic/Reticulocytes percentage) of the high absorption Reticulocytes to Total
reticulocytes to total reticulocytes Reticulocytes Ratio
C11618 High Absorption High Absorption Reticulocytes A measurement of the high High Absorption
8 Reticulocytes absorption reticulocytes in a Reticulocyte Measurement
C74754 Hippuric Acid Crystals Hippurate Crystals;Hippuric Acid Crystals A measurement of the hippuric Hippuric Acid Crystal
acid crystals present in a biological Measurement
specimen.
C80189 Histamine Histamine A measurement of the histamine Histamine Measurement

C12212 Histidine Histidine A measurement of the histidine in Histidine Measurement

page 813 of 1925

C6715 LBTEST
4
Code Value
C11229 Histone 1 Antibody Histone 1 Antibody A measurement of the total Histone 1 Antibody
3 histone 1 antibodies in a biological Measurement
specimen.
C11229 Histone 2A Antibody Histone 2A Antibody A measurement of the total Histone 2A Antibody
4 histone 2A antibodies in a Measurement
C11229 Histone 2B Antibody Histone 2B Antibody A measurement of the total Histone 2B Antibody
5 histone 2B antibodies in a Measurement
specimen.
specimen.
C11120 Histone Antibodies Anti-Histone Antibodies;Histone Antibodies A measurement of histone Histone Antibody
specimen.
C10652 HIV Antibody HIV Antibody A measurement of the HIV virus HIV Antibody
C74713 HIV-1 Antibody HIV-1 Antibody A measurement of the HIV-1 virus HIV-1 Antibody
C92263 HIV-1 Group M and O HIV-1 Group M and O Nucleic Acid A measurement of the HIV-1 HIV-1 Group M and O
Nucleic Acid group M and O nucleic acids in a Nucleic Acid Measurement
C92264 HIV-1 Group O Antibody HIV-1 Group O Antibody A measurement of the HIV-1 HIV-1 Group O Antibody
group O antibody in a biological Measurement
specimen.
C92265 HIV-1 p24 Antigen HIV-1 p24 Antigen A measurement of the HIV-1 p24 HIV-1 p24 Antigen
antigen in a biological specimen. Measurement
C74714 HIV-1/2 Antibody HIV-1/2 Antibody A measurement of either the HIV- HIV-1 HIV-2 Antibody
1 or HIV-2 virus antibody in a Measurement
C13908 HIV-1/2 Antibody + HIV-1 HIV-1/2 Antibody + HIV-1 p24 Antigen A measurement of the antibody HIV-1/2 Antibody and
5 p24 Antigen reaction of a biological specimen HIV-1 p24 Antigen
to either the HIV-1 or HIV-2 virus Measurement
and the measurement of HIV-1
p24 antigen in a biological
specimen.
C74715 HIV-2 Antibody HIV-2 Antibody A measurement of the HIV-2 virus HIV-2 Antibody
C92266 HIV-2 Nucleic Acid HIV-2 Nucleic Acid A measurement of the HIV-2 HIV-2 Nucleic Acid
nucleic acids in a biological Measurement
specimen.
C12896 HLA Class I Antibody HLA Class I Antibody A measurement of the human HLA Class I Antibody
4 leukocyte antigen (HLA) antibody Measurement
class I in a biological specimen.
C12896 HLA Class I Panel Reactive HLA Class I Panel Reactive Antibody A measurement of the panel HLA Class I Panel Reactive
7 Antibody reactive antibody (the reactivity Antibody Measurement
between host immune cells and
donor) human leukocyte antigen
class I in a biological specimen.
C15474 HLA Class IA Antigen HLA Class IA Antigen A measurement of the HLA class HLA Class IA
6 IA antigen in a biological Histocompatibility Antigen
C15474 HLA Class IB Antigen HLA Class IB Antigen A measurement of the HLA class HLA Class IB
7 IB antigen in a biological Histocompatibility Antigen
C15474 HLA Class IC Antigen HLA Class IC Antigen A measurement of the HLA class HLA Class IC
8 IC antigen in a biological Histocompatibility Antigen
page 814 of 1925

C6715 LBTEST
4
Code Value
C12896 HLA Class II Antibody HLA Class II Antibody A measurement of the human HLA Class II Antibody
5 leukocyte antigen (HLA) antibody Measurement
class II in a biological specimen.
C12896 HLA Class II Panel HLA Class II Panel Reactive Antibody A measurement of the panel HLA Class II Panel
6 Reactive Antibody reactive antibody (the reactivity Reactive Antibody
between host immune cells and Measurement
donor) human leukocyte antigen
class II in a biological specimen.
C15475 HLA DP Beta1 Antigen HLA DP Beta1 Antigen A measurement of the HLA DP HLA DP Beta1
1 beta1 antigen in a biological Histocompatibility Antigen
C15475 HLA DQ Beta1 Antigen HLA DQ Beta1 Antigen A measurement of the HLA DQ HLA DQ Beta1
C15474 HLA DR Beta1 Antigen HLA DR Beta1 Antigen A measurement of the HLA DR HLA DR Beta1
C12893 HLA Mismatch Count HLA Mismatch Count A measurement to determine the HLA Mismatch Count
3 number of mismatches between
the recipient and the donor for the
human leukocyte antigens (HLA).
C12895 HLA-A Antigen Type HLA-A Antigen Type The identification of the type of HLA-A Antigen Type
5 human leukocyte antigen, class I,
group A (HLA-A), in a biological
specimen.
C12895 HLA-A Mismatch Count HLA-A Mismatch Count A measurement to determine the HLA-A Mismatch Count
human leukocyte antigen, class I,
group A (HLA-A).
C12895 HLA-A2 Antibody HLA-A2 Antibody A measurement of the human HLA-A2 Antibody
4 leukocyte antigen A2 (HLA-A2) Measurement
C12895 HLA-A23 Antibody HLA-A23 Antibody A measurement of the human HLA-A23 Antibody
3 leukocyte antigen A23 (HLA-A23) Measurement
C12895 HLA-B Antigen Type HLA-B Antigen Type The identification of the type of HLA-B Antigen Type
7 human leukocyte antigen, class I,
group B (HLA-B), in a biological
specimen.
C12895 HLA-B Mismatch Count HLA-B Mismatch Count A measurement to determine the HLA-B Mismatch Count
human leukocyte antigen, class I,
group B (HLA-B).
C10046 HLA-B27 Antigen HLA-B27 Antigen;Human Leukocyte Antigen B27 A measurement of the human HLA-B27 Antigen
0 leukocyte antigen B27 (HLA-B27) Measurement
C12896 HLA-DR Antigen Type HLA-DR Antigen Type The identification of the type of HLA-DR Antigen Type
2 human leukocyte antigen, class II,
antigen-D-related (HLA-DR), in a
C12896 HLA-DR Mismatch Count HLA-DR Mismatch Count A measurement to determine the HLA-DR Mismatch Count
human leukocyte antigen, class II,
antigen-D-related (HLA-DR).
C12895 HLA-DR51 Antibody HLA-DR51 Antibody A measurement of the human HLA-DR51 Antibody
9 leukocyte antigen DR51 (HLA- Measurement
DR51) antibody in a biological
specimen.
specimen.
page 815 of 1925

C6715 LBTEST
4
Code Value
specimen.
C15475 Homocitrulline Homocitrulline A measurement of the Homocitrulline

8 homocitrulline in a biological Measurement
specimen.
C74741 Homocysteine Homocysteine A measurement of the Homocysteine Acid

homocysteine amino acid in a Measurement
C74863 Homovanillic Acid Homovanillic Acid A measurement of the Homovanillic Acid

homovanillic acid metabolite in a Measurement
C74704 Howell-Jolly Bodies Howell-Jolly Bodies A measurement of the Howell-Jolly Howell-Jolly Body
bodies (spherical, blue-black Measurement
condensed DNA inclusions within
the body of a red blood cell that
appear under Wright-stain) in a
C12212 HTLV-1/2 Antibody HTLV-1/2 Antibody;HTLV-I/II Antibody;Human A measurement of either the HTLV-I HTLV-II Antibody
5 T-cell Lymphotropic Virus 1/2 Antibody HTLV-1 or HTLV-2 virus antibody Measurement
C10340 Human Albumin Antibody Human Albumin Antibody A measurement of the human Human Albumin Antibody
5 albumin antibody in a biological Measurement
specimen.
C10340 Human Anti-Mouse HAMA;Human Anti-Mouse Antibody A measurement of the human Human Anti-Mouse
6 Antibody anti-mouse antibody in a biological Antibody Measurement
specimen.
C98740 Human Anti-Sheep IgE Human Anti-Sheep IgE Antibody A measurement of the human Human Anti-Sheep IgE
Antibody anti-sheep IgE antibodies in a Antibody Measurement
C98741 Human Anti-Sheep IgG Human Anti-Sheep IgG Antibody A measurement of the human Human Anti-Sheep IgG
Antibody anti-sheep IgG antibodies in a Antibody Measurement
C98742 Human Anti-Sheep IgM Human Anti-Sheep IgM Antibody A measurement of the human Human Anti-Sheep IgM
Antibody anti-sheep IgM antibodies in a Antibody Measurement
C11231 Human Epidermal Growth ERBB2;HER2/NEU;Human Epidermal Growth A measurement of HER2 protein in Human Epidermal Growth
2 Factor Receptor 2 Factor Receptor 2 a biological specimen. Factor Receptor 2
Measurement
C12761 Human Papillomavirus 11 Human Papillomavirus 11 Antibody A measurement of the human Human Papillomavirus 11
8 Antibody papillomavirus 11 antibody in a Antibody Measurement
C14227 Huntingtin Protein Huntingtin Protein A measurement of the huntingtin Huntingtin Protein
C14228 Huntingtin Protein, Mutant Huntingtin Protein, Mutant A measurement of the mutant Mutant Huntingtin Protein
0 huntingtin protein in a biological Measurement
specimen.
C74770 Hyaline Casts Hyaline Casts A measurement of the hyaline Hyaline Cast Measurement
casts present in a biological
specimen.
C11231 Hyaluronic Acid Hyaluronic Acid A measurement of hyaluronic acid Hyaluronic Acid
page 816 of 1925

C6715 LBTEST
4
Code Value
C74879 Hydrocodone Hydrocodone A measurement of the Hydrocodone

hydrocodone present in a Measurement
C10227 Hydrogen Hydrogen A measurement of the hydrogen in Hydrogen Measurement

C74880 Hydromorphone Hydromorphone A measurement of the Hydromorphone

hydromorphone present in a Measurement
C14735 Hydroxyalprazolam Hydroxyalprazolam A measurement of the total Hydroxyalprazolam

2 hydroxyalprazolam present in a Measurement
C15476 Hydroxylysine Hydroxylysine A measurement of the Hydroxylysine

7 hydroxylysine in a biological Measurement
specimen.
C80190 Hydroxyproline Hydroxyproline A measurement of the total Hydroxyproline

hydroxyproline in a biological Measurement
specimen.
C96669 Hyperchromia Hyperchromia A measurement of the prevalence Hyperchromia

of the erthrocytes with an elevated Measurement
hemoglobin concentration.
C74612 Hypersegmented Cells Hypersegmented Cells A measurement of the Hypersegmented

hypersegmented (more than five Neutrophil Measurement
lobes) neutrophils in a biological
specimen.
C64802 Hypochromia Hypochromia An observation which indicates Hypochromia

that the hemoglobin concentration
in a red blood cell specimen has
fallen below a specified level.
C11620 Hypogranular Neutrophils Hypogranular Neutrophils A measurement of the Hypogranular Neutrophil

1 hypogranular neutrophils in a Measurement
C11123 Icteric Index Icteric Index;Icterus A measurement of the yellow color Icteric Index
2 of a biological specimen, due to
the presence of bile pigments.
C11232 IDL Cholesterol IDL Cholesterol;Intermediate Density Lipoprotein A measurement of the Intermediate Density
5 intermediate density lipoprotein in Lipoprotein Cholesterol
C11619 IDL Particles IDL Particles;Intermediate Density Lipoproteins A measurement of the IDL Particles Measurement
7 Particles concentration of IDL particles in a
C14737 IDL+VLDL Cholesterol IDL Cholesterol and VLDL Cholesterol Subtype A measurement of the IDL Cholesterol and VLDL
1 Subtype 3 3;IDL+VLDL Cholesterol Subtype 3 intermediate density lipoprotein Cholesterol Subtype 3
cholesterol and the very low Measurement
density lipoprotein cholesterol
subtype 3 in a biological specimen.
C14737 IgG Clearance IgG Clearance A measurement of the IgG IgG Clearance
3 clearance in a biological specimen.
C14737 IgG Clearance/Albumin IgG Clearance/Albumin Clearance A relative measurement (ratio) of IgG Clearance to Albumin
4 Clearance the IgG clearance to albumin Clearance Ratio
clearance in a biological specimen. Measurement
C11123 IgG IgM IgA Total IgG IgM IgA Total A measurement of the total IgG, IgG IgM IgA Total
3 IgM, and IgA in a biological Measurement
specimen.
C14737 IgG Synthesis Rate IgG Synthesis Rate A measurement of the IgG IgG Synthesis Rate
5 synthesis rate in a biological
specimen.
C96670 Immature Basophils Immature Basophils A measurement of the immature Immature Basophil Count
basophils in a biological specimen.
C96671 Immature Immature Basophils/Leukocytes A relative measurement (ratio or Immature Basophil to

Basophils/Leukocytes percentage) of immature basophils Leukocyte Ratio
to total leukocytes in a biological Measurement
specimen.
page 817 of 1925

C6715 LBTEST
4
Code Value
C96672 Immature Cells Immature Cells A measurement of the total Immature Cell Count
immature cells in a blood
specimen.
C11123 Immature Cells/Total Cells Immature Cells/Total Cells A relative measurement (ratio or Immature Cell to Total Cell
4 percentage) of the immature Ratio Measurement
hematopoietic cells to total cells in
C96673 Immature Eosinophils Immature Eosinophils A measurement of the immature Immature Eosinophil
eosinophils in a biological Count
specimen.
C96674 Immature Immature Eosinophils/Leukocytes A relative measurement (ratio or Immature Eosinophil to

Eosinophils/Leukocytes percentage) of immature Leukocyte Ratio
eosinophils to total leukocytes in a Measurement
C96675 Immature Granulocytes Immature Granulocytes A measurement of the total Immature Granulocyte
immature granulocytes in a Count
C10044 Immature Immature Granulocytes/Leukocytes A relative measurement (ratio or Immature Granulocytes to

5 Granulocytes/Leukocytes percentage) of the immature Leukocytes Ratio
granulocytes to leukocytes in a Measurement
biological specimen (for example a
bone marrow specimen).
C12762 Immature Leukocytes Immature Leukocytes A measurement of the immature Immature Leukocyte
5 leukocytes in a biological Count
specimen.
C12762 Immature Immature Leukocytes/Leukocytes A relative measurement (ratio or Immature Leukocyte to

6 Leukocytes/Leukocytes percentage) of the immature Leukocytes Ratio
leukocytes to leukocytes in a Measurement
C10044 Immature Lymphocytes Immature Lymphocytes A measurement of the immature Immature Lymphocytes
4 lymphocytes in a biological Measurement
specimen.
C10044 Immature Immature Lymphocytes/Leukocytes A relative measurement (ratio or Immature Lymphocytes to

3 Lymphocytes/Leukocytes percentage) of the immature Leukocytes Ratio
lymphocytes to leukocytes in a Measurement
C96676 Immature Monocytes Immature Monocytes A measurement of the immature Immature Monocyte Count
monocytes in a biological
specimen.
C96677 Immature Immature Monocytes/Leukocytes A relative measurement (ratio or Immature Monocyte to

Monocytes/Leukocytes percentage) of immature Leukocyte Ratio
monocytes to total leukocytes in a Measurement
C96678 Immature Neutrophils Immature Neutrophils A measurement of the total Immature Neutrophil
immature neutrophils in a Count
C10044 Immature Immature Neutrophils/Leukocytes A relative measurement (ratio or Immature Neutrophils to

2 Neutrophils/Leukocytes percentage) of the immature Leukocytes Ratio
neutrophils to leukocytes in a Measurement
C96679 Immature Plasma Cells Immature Plasma Cells A measurement of the immature Immature Plasma Cell
plasma cells in a biological Count
specimen.
C96680 Immature Plasma Immature Plasma Cells/Lymphocytes A relative measurement (ratio or Immature Plasma Cell to
Cells/Lymphocytes percentage) of immature plasma Lymphocyte Ratio
cells to total lymphocytes in a Measurement
C14741 Immature Plasma Immature Plasma Cells/Total Cells A relative measurement (ratio or Immature Plasma Cells to
6 Cells/Total Cells percentage) of the immature Total Cells Ratio
plasma cells (plasmacytes) to total Measurement
C15472 Immature Platelets Immature Platelets;Reticulated Platelets A measurement of the immature Immature Platelet Count
3 platelets in a biological specimen.
page 818 of 1925

C6715 LBTEST
4
Code Value
C10227 Immature Reticulocyte Immature Reticulocyte Fraction A measurement of the immature Immature Reticulocyte
6 Fraction reticulocyte fraction present in a Fraction Measurement
C10340 Immunoblasts Immunoblastic Lymphocytes;Immunoblasts A measurement of the Immunoblast Count

7 immunoblasts in a biological
specimen.
C10653 Immunoblasts/Lymphocyte Immunoblasts/Lymphocytes;Lymphocytes, A relative measurement (ratio or Immunoblasts to

5 s Immunoblastic/Lymphocytes percentage) of immunoblasts to all Lymphocytes Ratio
lymphocytes present in a sample. Measurement
C81869 Immunoglobulin Immunoglobulin A measurement of the total Immunoglobulin

immunoglobulin in a biological Measurement
specimen.
C81969 Immunoglobulin A Immunoglobulin A A measurement of the total Immunoglobulin A

immunoglobulin A in a biological Measurement
specimen.
C98745 Immunoglobulin D Immunoglobulin D A measurement of the Immunoglobulin D

Immunoglobulin D in a biological Measurement
specimen.
C81970 Immunoglobulin E Immunoglobulin E A measurement of the Immunoglobulin E

Immunoglobulin E in a biological Measurement
specimen.
C81971 Immunoglobulin G Immunoglobulin G A measurement of the total Immunoglobulin G

immunoglobulin G in a biological Measurement
specimen.
C12212 Immunoglobulin G Immunoglobulin G Subclass 1 A measurement of the Immunoglobulin G

7 Subclass 1 immunoglobulin G subclass 1 in a Subclass 1 Measurement



C14737 Immunoglobulin IgG/Albumin;Immunoglobulin G/Albumin A relative measurement (ratio or Immunoglobulin G to

2 G/Albumin percentage) of the Albumin Ratio
immunoglobulin G to albumin in a Measurement
C11928 Immunoglobulin Immunoglobulin G/Creatinine A relative measurement (ratio or Immunoglobulin G to

5 G/Creatinine percentage) of the Creatinine Ratio
immunoglobulin G to creatinine in Measurement
C15473 Immunoglobulin Heavy Immunoglobulin Heavy Constant Gamma 2 A measurement of the Immunoglobulin Heavy
7 Constant Gamma 2 immunoglobulin heavy constant Constant Gamma 2
gamma 2 in a biological specimen. Measurement
C15473 Immunoglobulin Heavy Immunoglobulin Heavy Constant Gamma 4 A measurement of the Immunoglobulin Heavy
8 Constant Gamma 4 immunoglobulin heavy constant Constant Gamma 4
gamma 4 in a biological specimen. Measurement
C14737 Immunoglobulin Light Immunoglobulin Light Chains A measurement of the total Immunoglobulin Light
6 Chains immunoglobulin (kappa and Chain Measurement
lambda) light chains in a biological
specimen.
C81972 Immunoglobulin M Immunoglobulin M A measurement of the total Immunoglobulin M

immunoglobulin M in a biological Measurement
specimen.
C11618 Inclusion Bodies Inclusion Bodies A measurement of the inclusion Inclusion Body
4 bodies in a biological specimen. Measurement
C82044 Indican Indican A measurement of the indican Indican Measurement

page 819 of 1925

C6715 LBTEST
4
Code Value
C64483 Indirect Bilirubin Indirect Bilirubin A measurement of the Indirect Bilirubin

unconjugated or non-water- Measurement
soluble bilirubin in a biological
specimen.
C13011 Industrial Mix Antigen IgE Industrial Mix Antigen IgE Antibody A measurement of the industrial Industrial Mix Antigen IgE
4 Antibody mix antigen IgE antibody in a Antibody Measurement
C13011 Industrial Mix Antigen IgG Industrial Mix Antigen IgG Antibody A measurement of the industrial Industrial Mix Antigen IgG
5 Antibody mix antigen IgG antibody in a Antibody Measurement
C12067 Influenza A Antigen Influenza A Antigen A measurement of the influenza A Influenza A Antigen
C10340 Influenza A IgG Antibody Influenza A IgG Antibody A measurement of the Influenza A Influenza A IgG Antibody
specimen.
C12067 Influenza A/B Antigen Influenza A/B Antigen A measurement of the influenza A Influenza A/B Antigen
8 and/or B antigen in a biological Measurement
specimen.
C12067 Influenza B Antigen Influenza B Antigen A measurement of the influenza B Influenza B Antigen
C10340 Influenza B IgG Antibody Influenza B IgG Antibody A measurement of the Influenza B Influenza B IgG Antibody
specimen.
C82020 Inhibin A Inhibin A A measurement of the inhibin A in Inhibin A Measurement

C96681 Inhibin B Inhibin B A measurement of the inhibin B in Inhibin B Measurement

C74788 Insulin Insulin A measurement of the insulin in a Insulin Measurement

C11928 Insulin Antibody Insulin Antibody A measurement of the antibody to Insulin Antibody
7 insulin in a biological specimen. Measurement
C11928 Insulin Autoantibody Insulin Autoantibody A measurement of the antibody to Insulin Autoantibody
6 endogenous insulin in a biological Measurement
specimen.
C12345 Insulin Resistance Insulin Resistance A measurement of the insulin Insulin Resistance
8 resistance (a cell's inability to Measurement
respond to insulin) in a biological
specimen.
C12345 Insulin Sensitivity Insulin Sensitivity A measurement of the insulin Insulin Sensitivity
9 sensitivity (cells are stimulated by Measurement
lower than normal insulin levels)
C14737 Insulin, Free Insulin, Free A measurement of the free insulin Free Insulin Measurement
C12896 Insulin-Like Growth Factor Insulin-Like Growth Factor Binding Prot1;Insulin- A measurement of the total Insulin-Like Growth Factor
8 Binding Prot1 Like Growth Factor Binding Protein 1 insulin-like growth factor binding Binding Protein 1
protein 1 in a biological specimen. Measurement
C12896 Insulin-Like Growth Factor Insulin-Like Growth Factor Binding Prot2;Insulin- A measurement of the insulin-like Insulin-Like Growth Factor
9 Binding Prot2 Like Growth Factor Binding Protein 2 growth factor binding protein 2 in Binding Protein 2
C11232 Insulin-Like Growth Factor Insulin-Like Growth Factor Binding Prot3;Insulin- A measurement of the insulin-like Insulin-Like Growth Factor
2 Binding Prot3 Like Growth Factor Binding Protein 3 growth factor binding protein 3 in Binding Protein 3
C74864 Insulin-like Growth Factor- Insulin-like Growth Factor-1 A measurement of the insulin-like Insulin Like Growth
1 growth factor-1 in a biological Factor-1 Measurement
specimen.
C74865 Insulin-like Growth Factor- Insulin-like Growth Factor-2 A measurement of the insulin-like Insulin Like Growth
2 growth factor-2 in a biological Factor-2 Measurement
specimen.
page 820 of 1925

C6715 LBTEST
4
Code Value
C11928 Insulinoma-Associated Insulinoma-Associated Protein 2 Antibody A measurement of the insulinoma- Insulinoma-Associated

4 Protein 2 Antibody associated protein 2 antibody in a Protein 2 Antibody
C12434 Intercellular Adhesion Intercellular Adhesion Molecule A measurement of the total Intercellular Adhesion
4 Molecule intercellular adhesion molecule in Molecule Measurement
C12434 Intercellular Adhesion CD54;Intercellular Adhesion Molecule 1 A measurement of the intercellular Intercellular Adhesion
5 Molecule 1 adhesion molecule 1 in a biological Molecule 1 Measurement
specimen.
C81994 Interferon Alpha Interferon Alpha A measurement of the interferon Interferon Alpha
alpha in a biological specimen. Measurement
C81995 Interferon Beta Interferon Beta A measurement of the interferon Interferon Beta
beta in a biological specimen. Measurement
C81996 Interferon Gamma Interferon Gamma A measurement of the interferon Interferon Gamma
gamma in a biological specimen. Measurement
C74805 Interleukin 1 Interleukin 1 A measurement of the interleukin Interleukin 1 Measurement

C12213 Interleukin 1 Alpha Interleukin 1 Alpha A measurement of interleukin 1 Interleukin 1 Alpha

1 alpha in a biological specimen. Measurement
C11232 Interleukin 1 Beta IL-1B;IL1Beta;Interleukin 1 Beta;Interleukin 1B A measurement of interleukin 1 Interleukin 1 Beta

3 beta in a biological specimen. Measurement
C11232 Interleukin 1 Receptor IL-1RA;Interleukin 1 Receptor Antagonist A measurement of the interleukin Interleukin 1 Receptor
4 Antagonist 1 receptor antagonist in a Antagonist Measurement
C14228 Interleukin 1 Receptor-Like Interleukin 1 Receptor-Like 1 A measurement of the interleukin Interleukin 1 Receptor-
1 1 1 receptor-like 1 in a biological Like 1 Measurement
specimen.
C74806 Interleukin 10 Interleukin 10 A measurement of the interleukin Interleukin 10


C74808 Interleukin 12 Interleukin 12;Interleukin 12 p70 A measurement of the interleukin Interleukin 12

C12762 Interleukin 12 Beta Interleukin 12 Beta;Interleukin 12 p40 A measurement of interleukin 12 Interleukin 12 Beta
C12897 Interleukin 12+23 p40 Interleukin 12+23 p40 A measurement of the p40 subunit Interleukin 12+23 p40
0 of the interleukins 12 and 23 in a Measurement








C14228 Interleukin 2 Receptor IL-2Ra;Interleukin 2 Receptor Subunit Alpha A measurement of the interleukin Interleukin 2 Receptor
2 Subunit Alpha 2 receptor subunit alpha in a Subunit Alpha
page 821 of 1925

C6715 LBTEST
4
Code Value
C14228 Interleukin 2 Receptor IL-2Rb;Interleukin 2 Receptor Subunit Beta A measurement of the interleukin Interleukin 2 Receptor
3 Subunit Beta 2 receptor subunit beta in a Subunit Beta





















C11926 Intestinal Specific Alkaline Intestinal Specific Alkaline Phosphatase A measurement of the intestinal Intestinal Specific Alkaline
6 Phosphatase specific alkaline phosphatase Phosphatase Measurement
C12594 Inulin Inulin A measurement of the inulin in a Inulin Measurement

C98748 Inulin Clearance Inulin Clearance A measurement of the volume of Inulin Clearance
cleared of inulin by excretion of
(e.g. one minute).
C12594 Iohexol Iohexol A measurement of iohexol in a Iohexol Measurement

page 822 of 1925

C6715 LBTEST
4
Code Value
C10043 Iohexol Clearance Iohexol Clearance A measurement of the volume of Iohexol Clearance
9 serum or plasma that would be
cleared of Iohexol by excretion of
(e.g. one minute).
C98749 Iothalamate Clearance Iothalamate Clearance A measurement of the volume of Iothalamate Clearance
cleared of iothalamate by
unit of time (e.g. one minute).
C98750 Iothalamate Clearance Iothalamate Clearance Adjusted for BSA A measurement of the volume of Iothalamate Clearance
Adjusted for BSA serum or plasma that would be Adjusted for BSA
cleared of iothalamate by
unit of time (e.g. one minute),
adjusted for body surface area.
C74679 Iron FE;Iron A measurement of the iron in a Iron Measurement

C15081 Iron Excretion Rate Iron Excretion Rate A measurement of the amount of Iron Excretion Rate
9 iron being excreted in a biological
specimen over a defined amount
of time (e.g. one hour).
C12762 Islet Amyloid Polypeptide Amylin;Islet Amyloid Polypeptide A measurement of the islet Islet Amyloid Polypeptide
2 amyloid polypeptide in a biological Measurement
specimen.
C13542 Islet Antigen 2 ICA-512;Islet Antigen 2 Autoantibody;Islet Cell A measurement of the antibody to Islet Antigen 2
9 Autoantibody Antigen 512 Autoantibody endogenous islet antigen 2 in a Autoantibody
C81985 Islet Cell 512 Antibody Islet Cell 512 Antibody A measurement of the islet cell Islet Cell 512 Antibody
512 antibody in a biological Measurement
specimen.
C81986 Islet Cell 512 Antigen Islet Cell 512 Antigen A measurement of the islet cell Islet Cell 512 Antigen
512 antigen in a biological Measurement
specimen.
C15472 Islet Cell Antibody Islet Cell Antibody A measurement of the total islet Islet Cell Antibody
5 cell antibodies in a biological Measurement
specimen.
C12212 Islet Cell Cytoplasmic IgG Islet Cell Cytoplasmic IgG Antibody A measurement of the islet cell Islet Cell Cytoplasmic IgG
6 Antibody cytoplasmic IgG antibody in a Antibody Measurement
C81987 Islet Neogenesis Assoc Islet Neogenesis Assoc Protein Antibody A measurement of the islet Islet Neogenesis
Protein Antibody neogenesis associated protein Associated Protein
antibody in a biological specimen. Antibody Measurement
C10341 Isoleucine Isoleucine A measurement of the isoleucine Isoleucine Measurement

C14737 Japanese Encephalitis Japanese Encephalitis Virus Antibody A measurement of the Japanese Japanese Encephalitis
8 Virus Antibody encephalitis virus antibody in a Virus Antibody
C11232 JC Virus Antibody JC Polyomavirus Antibody;JC Virus Antibody;JCV A measurement of the JC virus JC Virus Antibody
6 Antibody;John Cunningham Virus Antibody antibody in a biological specimen. Measurement
C10045 Jo-1 Antibody Jo-1 Antibody A measurement of the Jo-1 Jo-1 Antibody
C13237 Kallikrein-2 Kallikrein-2 A measurement of the kallikrein-2 Kallikrein-2 Measurement

C14737 Kappa Light Chain Kappa Light Chain A measurement of the total kappa Kappa Light Chain
9 light chains in a biological Measurement
specimen.
C98730 Kappa Light Chain, Free Bence-Jones, Kappa;Kappa Light Chain, Free A measurement of the free kappa Free Kappa Light Chain
light chain in a biological Measurement
specimen.
C98731 Kappa Lt Kappa Lt Chain,Free/Lambda Lt Chain,Free A relative measurement (ratio or Free Kappa Light Chain to
Chain,Free/Lambda Lt percentage) of the free kappa light Free Lambda Light Chain
Chain,Free chain to the free lambda light Ratio Measurement
chain in a biological specimen.
page 823 of 1925

C6715 LBTEST
4
Code Value
C14738 Keratocyte Keratocyte A measurement of the keratocytes Keratocyte Count

C11123 Ketone Bodies Ketone Bodies A measurement of the ketone Ketone Body Measurement
9 bodies (acetone, acetoacetic acid,
beta-hydroxybutyric acid, beta-
ketopentanoate and beta-
hydroxypentanoate) in a biological
specimen.
C64854 Ketones Ketones A measurement of the ketones in Ketone Measurement

C13237 Keyhole Limpet Keyhole Limpet Hemocyanin IgG Antibody A measurement of the keyhole Keyhole Limpet
2 Hemocyanin IgG Antibody limpet hemocyanin IgG antibody in Hemocyanin IgG Antibody
C13237 Keyhole Limpet Keyhole Limpet Hemocyanin IgM Antibody A measurement of the keyhole Keyhole Limpet
3 Hemocyanin IgM Antibody limpet hemocyanin IgM antibody Hemocyanin IgM Antibody
C10043 Kidney Injury Molecule-1 Hepatitis A Virus Cellular Receptor 1;KIM- A measurement of the kidney Kidney Injury Molecule-1
3 1;Kidney Injury Molecule-1 injury molecule-1 (Kim-1) in a Measurement
C12762 Klotho Klotho A measurement of the total klotho Klotho Protein

C15472 Krebs von den Lungen-6 KL-6;Krebs von den Lungen-6 Antigen A measurement of the Krebs von Krebs von den Lungen-6
4 den Lungen-6 in a biological Measurement
specimen.
C96682 Kurloff Cells Kurloff Cells A measurement of the large Kurloff Cells Measurement
secretory granule-containing
immune cells in a biological
specimen taken from members of
certain genera of the Caviidae
family.
C15474 Kynurenine Kynurenine A measurement of the kynurenine Kynurenine Measurement

C64855 Lactate Dehydrogenase Lactate Dehydrogenase A measurement of the lactate Lactate Dehydrogenase
specimen.
C79449 Lactate Lactate Dehydrogenase/Creatinine A relative measurement (ratio or Lactate Dehydrogenase to

Dehydrogenase/Creatinine percentage) of the lactate Creatinine Ratio
dehydrogenase to creatinine in a Measurement
C79450 Lactic Acid 2-hydroxypropanoic acid;Lactate;Lactic Acid A measurement of the lactic acid Lactic Acid Measurement
C82021 Lactoferrin Lactoferrin;Lactotransferrin A measurement of the lactoferrin Lactoferrin Measurement

C12063 Lactoferrin Antibody Lactoferrin Antibody A measurement of the lactoferrin Lactoferrin Antibody
C15474 Lactulose Lactulose A measurement of the lactulose in Lactulose Measurement

C14738 Lambda Light Chain Lambda Light Chain A measurement of the total Lambda Light Chain
4 lambda light chains in a biological Measurement
specimen.
C98732 Lambda Light Chain, Free Bence-Jones, Lambda;Lambda Light Chain, Free A measurement of the free lambda Free Lambda Light Chain
light chain in a biological Measurement
specimen.
C74729 Large Platelets Large Platelets A measurement of the large Large Platelet Count
(between 4 um and 7um in
diameter) platelets in a biological
specimen.
C74659 Large Unstained Cells Large Unstained Cells A measurement of the large, Large Unstained Cell
peroxidase-negative cells which Count
cannot be further characterized
(i.e. as large lymphocytes,
virocytes, or stem cells) present in
page 824 of 1925

C6715 LBTEST
4
Code Value
C79467 Large Unstained Large Unstained Cells/Leukocytes A relative measure (ratio or Large Unstained Cells to
Cells/Leukocytes percentage) of the large unstained Leukocytes Ratio
cells to leukocytes in a biological Measurement
specimen.
C74887 LDH Isoenzyme 1 LDH Isoenzyme 1 A measurement of the lactate Lactate Dehydrogenase
dehydrogenase isoenzyme 1 in a Isoenzyme 1 Measurement
C79451 LDH Isoenzyme 1/LDH LDH Isoenzyme 1/LDH A relative measurement (ratio or LDH Isoenzyme 1 to LDH
percentage) of the lactate Ratio Measurement
dehydrogenase isoenzyme 1 to
total lactate dehydrogenase in a
C10558 LDL Cholesterol LDL Cholesterol A measurement of the low density Low Density Lipoprotein
8 lipoprotein cholesterol in a Cholesterol Measurement
C12118 LDL Cholesterol/HDL LDL Cholesterol/HDL Cholesterol A relative measurement (ratio or LDL Cholesterol to HDL
2 Cholesterol percentage) of the low density Cholesterol Ratio
lipoprotein cholesterol to high Measurement
density lipoprotein cholesterol in a
C10341 LDL Particle Size LDL Particle Size A measurement of the average LDL Particle Size
2 particle size of low-density Measurement
lipoprotein in a biological
specimen.
C12063 LDL Particles LDL Particles A measurement of the LDL Particles Measurement
6 concentration of the total LDL
particles in a biological specimen.
C12063 LDL Subtype Pattern LDL Subtype Pattern A description of the low density LDL Subtype Pattern
7 lipoprotein particle pattern (an
interpretation of the amounts of
LDL particles based on size and
density) in a biological specimen.
C14738 Lead Lead;Pb A measurement of the lead in a Lead Measurement

page 825 of 1925

C6715 LBTEST
4
Code Value
C14738 Lecithin/Sphingomyelin LS Ratio;Lecithin/Sphingomyelin A relative measurement (ratio) of Lecithin to Sphingomyelin

1 the lecithin to sphingomyelin in a Ratio Measurement
C11620 Left Shift Neutrophils Left Shift Neutrophils An observation of the above Left Shift Neutrophil
2 normal incidence of immature Measurement
neutrophils, including band
neutrophils and neutrophil
precursors in a biological
specimen.
C92275 Legionella pneumophila Legionella pneumophila Antigen A measurement of the Legionella Legionella pneumophila
Antigen pneumophila antigen in a Antigen Measurement
C92276 Legionella pneumophila Legionella pneumophila IgG Antibody A measurement of the Legionella Legionella pneumophila
IgG Antibody pneumophila IgG antibody in a IgG Antibody
C92277 Legionella pneumophila Legionella pneumophila IgG IgM Antibody A measurement of the Legionella Legionella pneumophila
IgG IgM Antibody pneumophila IgG and IgM in a IgG IgM Antibody
C92278 Legionella pneumophila Legionella pneumophila IgM Antibody A measurement of the Legionella Legionella pneumophila
IgM Antibody pneumophila IgM antibody in a IgM Antibody
C74866 Leptin Leptin A measurement of the leptin Leptin Measurement

C12213 Leucine Leucine A measurement of the leucine in a Leucine Measurement

C12213 Leucine Aminopeptidase Leucine Aminopeptidase A measurement of the total Leucine Aminopeptidase
2 leucine aminopeptidase present in Measurement
C74680 Leucine Crystals Leucine Crystals A measurement of the leucine Leucine Crystal
specimen.
C13016 Leukemia Inhibitory Factor Leukemia Inhibitory Factor A measurement of leukemia Leukemia Inhibitory Factor
3 inhibitory factor in a biological Measurement
specimen.
C74630 Leukemic Blasts Leukemic Blasts A measurement of the leukemic Leukemic Blast Count
blasts (lymphoblasts that remain
in an immature state even when
outside the bone marrow) in a
C74641 Leukemic Leukemic Blasts/Lymphocytes A relative measurement (ratio or Leukemic Blast to

Blasts/Lymphocytes percentage) of the leukemic blasts Lymphocyte Ratio
(immature lymphoblasts) to Measurement
mature lymphocytes in a biological
specimen.
C11619 Leukemic Cells Leukemic Cells;Residual Leukemic Cells A measurement of the leukemic Leukemic Cells
5 cells in a biological specimen. Measurement
C92246 Leukocyte Cell Clumps Leukocyte Cell Clumps;WBC Clumps;White Blood A measurement of white blood cell Leukocyte Cell Clumps
Cell Clumps clumps in a biological specimen. Measurement
C92297 Leukocyte Cell Morphology Leukocyte Cell Morphology;WBC An examination or assessment of Leukocyte Cell Morphology
Morphology;White Blood Cell Morphology the form and structure of white
blood cells.
C64856 Leukocyte Esterase Leukocyte Esterase A measurement of the enzyme Leukocyte Esterase
which indicates the presence of Measurement
white blood cells in a biological
specimen.
C51948 Leukocytes Leukocytes;White Blood Cells A measurement of the leukocytes Leukocyte Count
C13545 Leukocytes/Total Cells Leukocytes/Total Cells;WBC/Total Cells A relative measurement (ratio or Leukocytes to Total Cells
1 percentage) of the leukocytes to Ratio Measurement
C10341 Leukotriene B4 Leukotriene B4 A measurement of the leukotriene Leukotriene B4

3 B4 in a biological specimen. Measurement
page 826 of 1925

C6715 LBTEST
4
Code Value
C10341 Leukotriene D4 Leukotriene D4 A measurement of the leukotriene Leukotriene D4

4 D4 in a biological specimen. Measurement
C10341 Leukotriene E4 Leukotriene E4 A measurement of the leukotriene Leukotriene E4

5 E4 in a biological specimen. Measurement
C14738 Leuks Corrected for Nucl Leukocytes Corrected for Nucleated A measurement of the leukocytes Leukocytes Corrected for
3 Erythrocytes Erythrocytes;Leuks Corrected for Nucl corrected for nucleated Nucleated Erythrocytes
Erythrocytes erythrocytes in a biological Count
specimen.
C14738 Levetiracetam Levetiracetam A measurement of the Levetiracetam

6 levetiracetam in a biological Measurement
specimen.
C11774 Lipase Lipase;Total Lipase A measurement of the total lipase Lipase Measurement
C11784 Lipase, Gastric Gastric Triacylglycerol Lipase;LIPF;Lipase, A measurement of the gastric Gastric Lipase
0 Gastric triacylglycerol lipase in a biological Measurement
specimen.
C11784 Lipase, Lysosomal Acid Acid Cholesteryl Ester A measurement of the lysosomal Lysosomal Acid Lipase
2 Hydrolase;LAL;LIPA;Lipase, Lysosomal acid lipase in a biological Measurement
Acid;Lysosomal Lipase specimen.
C11784 Lipase, Pancreatic Lipase, Pancreatic;PNLIP;Pancreatic A measurement of the pancreatic Pancreatic Lipase
1 Triacylglycerol Lipase triacylglycerol lipase in a biological Measurement
specimen.
C11124 Lipemic Index Lipemia;Lipemic Index A measurement of the abnormally Lipemic Index
2 high concentration of lipid in a
C74949 Lipid Lipid;Total Lipid A measurement of the total lipids Lipid Measurement
(cholesterol, lipoproteins, and
triglycerides) in a biological
specimen.
C12594 Lipoarabinomannan Lipoarabinomannan A measurement of the Lipoarabinomannan

7 lipoarabinomannan in a biological Measurement
specimen.
C10653 Lipocalin-2 Lipocalin-2 A measurement of lipocalin-2 in a Lipocalin-2 Measurement

C10654 Lipocalin-2/Creatinine Lipocalin-2/Creatinine A relative measurement (ratio or Lipocalin-2 to Creatinine

0 percentage) of the lipocalin-2 to Ratio Measurement
C12063 Lipoprotein Associated Lipoprotein Associated Phospholipase A2 A measurement of the lipoprotein Lipoprotein Associated
8 Phospholipase A2 associated phospholipase A2 in a Phospholipase A2
C82022 Lipoprotein-a Lipoprotein-a A measurement of the lipoprotein- Lipoprotein a

a in a biological specimen. Measurement
C14228 Liquefaction Time Liquefaction Time A measurement of the time it Liquefaction Time
4 takes for a gelatinous or semi- Measurement
solid substance to change to a
liquid.
C14738 Liver Fibrosis Score Liver Fibrosis Score A biomarker test that measures Liver Fibrosis Score
5 liver pathology through the
assessment of multiple blood test
parameters, taking into account
the age and gender of the patient.
C96683 Liver Kidney Microsomal LKM-1;Liver Kidney Microsomal Type 1 Antibody A measurement of the liver kidney Liver Kidney Microsomal
Type 1 Antibody microsomal type 1 antibody in a Type 1 Antibody
C10045 Liver Kidney Microsomal Liver Kidney Microsomal Type 1 IgA Ab A measurement of the liver kidney Liver Kidney Microsomal
6 Type 1 IgA Ab microsomal type 1 IgA antibodies Type 1 IgA Antibody
C10045 Liver Kidney Microsomal Liver Kidney Microsomal Type 1 IgG Ab A measurement of the liver kidney Liver Kidney Microsomal
4 Type 1 IgG Ab microsomal type 1 IgG antibodies Type 1 IgG Antibody
C10045 Liver Kidney Microsomal Liver Kidney Microsomal Type 1 IgM Ab A measurement of the liver kidney Liver Kidney Microsomal
5 Type 1 IgM Ab microsomal type 1 IgM antibodies Type 1 IgM Antibody
page 827 of 1925

C6715 LBTEST
4
Code Value
C11926 Liver Specific Alkaline Liver Specific Alkaline Phosphatase A measurement of the liver Liver Specific Alkaline
7 Phosphatase specific alkaline phosphatase Phosphatase Measurement
C75374 Lorazepam Lorazepam A measurement of the lorazepam Lorazepam Measurement

C11619 Low Absorption Low Absorption Retic/Reticulocytes A relative measurement (ratio or Low Absorption
1 Retic/Reticulocytes percentage) of the low absorption Reticulocytes to Total
reticulocytes to total reticulocytes Reticulocytes Ratio
C11619 Low Absorption Low Absorption Reticulocytes A measurement of the low Low Absorption
C10227 Lupus Anticoagulant APTT-LA;Lupus Anticoagulant Sensitive APTT A measurement of the length of Lupus Anticoagulant
7 Sensitive APTT time that it takes for clotting to Sensitive APTT
occur when a lupus sensitive Measurement
reagent is added to a plasma
specimen.
C74790 Luteinizing Hormone Luteinizing Hormone;Lutropin A measurement of the luteinizing Luteinizing Hormone
hormone in a biological specimen. Measurement
C10227 Lymphoblasts Lymphoblasts A measurement of the Lymphoblast Count

8 lymphoblasts (immature cells that
differentiate to form lymphocytes)
C10544 Lymphoblasts/Leukocytes Lymphoblasts/Leukocytes A relative measurement (ratio or Lymphoblast to Leukocyte

4 percentage) of the lymphoblasts to Ratio Measurement
specimen.
C51949 Lymphocytes Lymphocytes A measurement of the Lymphocyte Count

lymphocytes in a biological
specimen.
C11928 Lymphocytes Activated Lymphocytes Activated A measurement of the total Activated Lymphocytes
9 activated lymphocytes in a Measurement
C64818 Lymphocytes Atypical Lymphocytes Atypical;Lymphocytes, Variant A measurement of the atypical Atypical Lymphocyte
lymphocytes in a biological Count
specimen.
C64819 Lymphocytes Lymphocytes Atypical/Leukocytes;Lymphocytes, A relative measurement (ratio or Atypical Lymphocyte to

Atypical/Leukocytes Variant/Leukocytes percentage) of the atypical Leukocyte Ratio
lymphocytes to leukocytes in a
C14738 Lymphocytes, Clefted Lymphocytes, Clefted A measurement of the clefted Clefted Lymphocytes
7 lymphocytes in a biological Count
specimen.
C14738 Lymphocytes, Lymphocytes, Clefted/Leukocytes A relative measurement (ratio or Clefted Lymphocytes to

8 Clefted/Leukocytes percentage) of the clefted Leukocytes Ratio
lymphocytes to total leukocytes in Measurement
C64820 Lymphocytes/Leukocytes Lymphocytes/Leukocytes A relative measurement (ratio or Lymphocyte to Leukocyte

percentage) of the lymphocytes to Ratio
specimen.
C13543 Lymphocytes/Non-Squam Lymphocytes/Non-Squam Epi Cells A relative measurement (ratio or Lymphocytes to Non-
0 Epi Cells percentage) of the lymphocytes to Squamous Epithelial Cells
C98751 Lymphocytes/Total Cells Lymphocytes/Total Cells A relative measurement (ratio or Lymphocyte to Total Cell
percentage) of the lymphocytes to Ratio Measurement
specimen).
C13906 Lymphoid Cells Lymphoid Cells A measurement of the total Lymphoid Cell Count
4 lymphoid lineage cells in a
page 828 of 1925

C6715 LBTEST
4
Code Value
C74613 Lymphoma Cells Lymphoma Cells A measurement of the malignant Lymphoma Cell Count
specimen.
C14738 Lymphoma Lymphoma Cells/Leukocytes A relative measurement (ratio or Lymphoma Cells to

9 Cells/Leukocytes percentage) of the malignant Leukocytes Ratio
lymphocytes to all leukocytes in a Measurement
C74910 Lymphoma Lymphoma Cells/Lymphocytes A relative measurement (ratio or Lymphoma Cell to

Cells/Lymphocytes percentage) of the malignant Lymphocyte Ratio
lymphocytes to all lymphocytes in Measurement
C81955 Lymphotactin Chemokine Ligand 1;Lymphotactin A measurement of the Lymphotactin

lymphotactin in a biological Measurement
specimen.
C13237 Lymphotoxin Alpha Lymphotoxin Alpha;TNF-beta;Tumor Necrosis A measurement of the Lymphotoxin Alpha
5 Factor Beta lymphotoxin alpha in a biological Measurement
specimen.
C75354 Lysergic Acid Diethylamide Acid;Lysergate Diethylamide;Lysergic Acid A measurement of the lysergic Lysergide Measurement
Diethylamide acid diethylamine (LSD) in a
C12213 Lysine Lysine A measurement of the lysine in a Lysine Measurement

C12064 Lysozyme Lysozyme A measurement of lysozyme in a Lysozyme Measurement

C92241 M. tuberculosis IFN M. tuberculosis IFN Gamma A measurement of the amount of Mycobacterium
Gamma Response Response;Mycobacterium tuberculosis IFN interferon gamma that is released tuberculosis Interferon
Gamma Response when Mycobacterium tuberculosis Gamma Response
antigen is incubated with a
biological specimen, usually blood.
Increased amounts of interferon
gamma suggests a prior or
existing M. tuberculosis infection.
C11124 Macroamylase Macroamylase A measurement of macroamylase Macroamylase

C64821 Macrocytes Macrocytes A measurement of the macrocytes Macrocyte Count

C80191 Macrophage Colony Macrophage Colony Stimulating Factor A measurement of the Macrophage Colony
Stimulating Factor macrophage colony stimulating Stimulating Factor
C82023 Macrophage Inflammatory Chemokine Ligand 3;Macrophage Inflammatory A measurement of the Macrophage Inflammatory
Protein 1 Alpha Protein 1 Alpha macrophage inflammatory protein Protein 1 Alpha
1 alpha in a biological specimen. Measurement
C82024 Macrophage Inflammatory Chemokine Ligand 4;Macrophage Inflammatory A measurement of the Macrophage Inflammatory
Protein 1 Beta Protein 1 Beta macrophage inflammatory protein Protein 1 Beta
C13016 Macrophage Inflammatory Macrophage Inflammatory Protein 1 Gamma A measurement of the Macrophage Inflammatory
4 Protein 1 Gamma macrophage inflammatory protein Protein 1 Gamma
1 gamma in a biological specimen. Measurement
C81956 Macrophage-Derived Chemokine Ligand 22;Macrophage-Derived A measurement of the Macrophage-Derived

Chemokine Chemokine macrophage-derived chemokine in Chemokine Measurement
C74798 Macrophages Macrophages A measurement of the Macrophage Count

macrophages in a biological
specimen.
C12346 Macrophages/Leukocytes Macrophages/Leukocytes A relative measurement (ratio or Macrophage to Leukocyte

0 percentage) of the macrophages Ratio
to leukocytes in a biological
specimen.
C13543 Macrophages/Non-Squam Macrophages/Non-Squam Epi Cells A relative measurement (ratio or Macrophages to Non-
1 Epi Cells percentage) of the macrophages Squamous Epithelial Cells
to non-squamous epithelial cells in Ratio Measurement
page 829 of 1925

C6715 LBTEST
4
Code Value
C11124 Macrophages/Total Cells Macrophages/Total Cells A relative measurement (ratio or Macrophage to Total Cell
4 percentage) of the macrophages Ratio Measurement
specimen.
C14739 Macroscopic Blood Macroscopic Blood;Visible Blood A measurement of the blood in Macroscopic Blood
0 body products such as a urine or Measurement
stool sample, and visibly
detectable on gross examination.
C64840 Magnesium Magnesium A measurement of the magnesium Magnesium Measurement

C79456 Magnesium/Creatinine Magnesium/Creatinine A relative measurement (ratio or Magnesium to Creatinine

percentage) of the magnesium to Ratio Measurement
C74660 Malignant Cells, NOS Malignant Cells, NOS A measurement of the malignant Malignant Cell Count
cells of all types in a biological
specimen.
C74643 Malignant Cells, Malignant Cells, NOS/Blood Cells A relative measurement (ratio or Malignant Cell to Blood
NOS/Blood Cells percentage) of the malignant cells Cell Ratio Measurement
of all types to all blood cells in a
C15474 Mannitol Mannitol A measurement of the mannitol in Mannitol Measurement

C11124 Mast Cells Mast Cells;Mastocytes A measurement of the mast cells Mast Cell Count
C11124 Mast Cells/Total Cells Mast Cells/Total Cells A relative measurement (ratio or Mast Cell to Total Cell
7 percentage) of the mast cells to Ratio Measurement
C80192 Matrix Metalloproteinase 1 Interstitial Collagenase;Matrix Metalloproteinase A measurement of the matrix Matrix Metalloproteinase 1
1 metalloproteinase 1 in a biological Measurement
specimen.
C80193 Matrix Metalloproteinase 2 Gelatinase A;Matrix Metalloproteinase 2 A measurement of the matrix Matrix Metalloproteinase 2
metalloproteinase 2 in a biological Measurement
specimen.
C80194 Matrix Metalloproteinase 3 Matrix Metalloproteinase 3;Stromelysin 1 A measurement of the matrix Matrix Metalloproteinase 3
specimen.
C80195 Matrix Metalloproteinase 7 Matrilysin;Matrix Metalloproteinase 7 A measurement of the matrix Matrix Metalloproteinase 7
specimen.
C80196 Matrix Metalloproteinase 8 Matrix Metalloproteinase 8;Neutrophil A measurement of the matrix Matrix Metalloproteinase 8
Collagenase metalloproteinase 8 in a biological Measurement
specimen.
C80197 Matrix Metalloproteinase 9 Gelatinase B;Matrix Metalloproteinase 9 A measurement of the matrix Matrix Metalloproteinase 9
specimen.
C74661 Mature Plasma Cells Mature Plasma Cells;Plasmacytes A measurement of the mature Mature Plasma Cell Count
plasma cells (plasmacytes) in a
C74911 Mature Plasma Mature Plasma Cells/Lymphocytes A relative measurement (ratio or Mature Plasma Cell to
Cells/Lymphocytes percentage) of the mature plasma Lymphocyte Ratio
cells (plasmacytes) to all Measurement
specimen.
C98869 Mature Plasma Cells/Total Mature Plasma Cells/Total Cells A relative measurement (ratio or Plasma Cell to Total Cell
Cells percentage) of the mature plasma Ratio Measurement
cells (plasmacytes) to total cells in
a biological specimen (for example
a bone marrow specimen).
C12762 Maturing Erythroid Maturing Erythroid/Total Cells A relative measurement (ratio or Maturing Erythroid Cell to
8 Cells/Total Cells percentage) of the maturing Total Cell Ratio
erythroid cells to total cells in a Measurement
page 830 of 1925

C6715 LBTEST
4
Code Value
C12762 Maturing Myeloid Maturing Myeloid/Total Cells A relative measurement (ratio or Maturing Myeloid Cell to
9 Cells/Total Cells percentage) of the maturing Total Cell Ratio
myeloid cells to total cells in a Measurement
C74614 May-Hegglin Anomaly May-Hegglin Anomaly A measurement of the May- May-Hegglin Anomaly
Hegglin anomaly in a blood Measurement
sample. This anomaly is
characterized by large, misshapen
platelets and the presence of
Dohle bodies in leukocytes.
C11421 MCV Reticulocytes MCV Reticulocytes;MCVr;Mean Corpuscular A measurement of the mean Reticulocyte Mean
5 Volume Reticulocytes volume of reticulocytes in a Corpuscular Volume
C96686 Mean Platelet Component Mean Platelet Component A measurement of the mean Mean Platelet Component
platelet component (platelet Measurement
activity) in a blood specimen.
C11421 Mean Platelet Dry Mass Mean Platelet Dry Mass A measurement of the mean Mean Platelet Dry Mass
4 platelet dry mass in a biological
specimen.
C74730 Mean Platelet Volume Mean Platelet Volume A measurement of the average Mean Platelet Volume
size of the platelets present in a Measurement
blood sample.
C14739 Meconium Meconium A measurement of the meconium Meconium Measurement

C13907 Medazepam Medazepam A measurement of the Medazepam Measurement

9 medazepam present in a biological
specimen.
C11619 Medium Absorption Medium Absorption Retic/Reticulocytes A relative measurement (ratio or Medium Absorption
3 Retic/Reticulocytes percentage) of the medium Reticulocytes to Total
absorption reticulocytes to total Reticulocytes Ratio
reticulocytes in a biological Measurement
specimen.
C11619 Medium Absorption Medium Absorption Reticulocytes A measurement of the medium Medium Absorption
C98752 Megakaryoblasts Megakaryoblasts A measurement of the Megakaryoblast Cell Count

megakaryoblasts in a biological
specimen.
C98753 Megakaryoblasts/Total Megakaryoblasts/Total Cells A relative measurement (ratio or Megakaryoblast to Total

Cells percentage) of the Cell Ratio Measurement
megakaryoblasts to total cells in a
C13543 Megakaryocyte and Megakaryocyte and Megakaryoblast An examination or assessment of Megakaryocyte and
2 Megakaryoblast Morph Morph;Megakaryocyte and Megakaryoblast the form and structure of Megakaryoblast
Morphology megakaryoblasts and Morphology Assessment
megakaryocytes.
C96688 Megakaryocytes Megakaryocytes A measurement of the Megakaryocyte Count

megakaryocytes per unit of a
C15472 Megakaryocytes/Leukocyte Megakaryocytes/Leukocytes A relative measurement (ratio or Megakaryocytes to

2 s percentage) of the Leukocytes Ratio
megakaryocytes to leukocytes in a Measurement
C98867 Megakaryocytes/Total Megakaryocytes/Total Cells A relative measurement (ratio or Megakaryocyte to Total

Cells percentage) of the Cell Ratio Measurement
megakaryocytes to total cells in a
C74867 Melatonin Melatonin A measurement of the melatonin Melatonin Measurement

C11125 Meningeal Cells Meningeal Cells A measurement of the mengingeal Meningeal Cell Count
page 831 of 1925

C6715 LBTEST
4
Code Value
C11125 Meningeal Cells/Total Cells Meningeal Cells/Total Cells A relative measurement (ratio or Meningeal Cell to Total
1 percentage) of the meningeal cells Cell Ratio Measurement
specimen.
C14739 Meperidine Meperidine A measurement of the meperidine Meperidine Measurement

C14739 Mercury Hg;Mercury A measurement of the mercury in Mercury Measurement

C14739 Mesothelial Cells Mesothelial Cells A measurement of the mesothelial Mesothelial Cells Count
C14739 Mesothelial Mesothelial Cells/Leukocytes A relative measurement (ratio or Mesothelial Cells to

9 Cells/Leukocytes percentage) of the mesothelial Leukocytes Ratio
cells to total leukocytes in a Measurement
C74615 Metamyelocytes Metamyelocytes A measurement of the Metamyelocyte Count

metamyelocytes (small,
myelocytic neutrophils with an
indented nucleus) in a biological
specimen.
C74645 Metamyelocytes/Leukocyte Metamyelocytes/Leukocytes A relative measurement (ratio or Metamyelocyte to

s percentage) of the Leukocyte Ratio
metamyelocytes (small, Measurement
indented nucleus) to all leukocytes
C98754 Metamyelocytes/Total Metamyelocytes/Total Cells A relative measurement (ratio or Metamyelocyte to Total

Cells percentage ) of the Cell Ratio Measurement
metamyelocytes (small,
indented nucleus) to total cells in
a biological specimen (for example
a bone marrow specimen).
C11619 Metanephrine Metadrenaline;Metanephrine A measurement of the Metanephrine

8 metanephrine in a biological Measurement
specimen.
C14740 Metanephrine, Free Metanephrine, Free A measurement of the free Free Metanephrine
0 metanephrine in a biological Measurement
specimen.
C12897 Metarubricyte Metarubricyte;Orthochromatophilic A measurement of the Metarubricyte Count

2 Normoblast;Orthochromic metarubricytes in a biological
Erythroblast;Orthochromic Normoblast specimen.
C12897 Metarubricyte/Total Cells Metarubricyte/Total Cells A relative measurement (ratio or Metarubricyte to Total Cell
1 percentage) of the metarubricytes Ratio Measurement
specimen.
C74881 Methadone Methadone A measurement of the methadone Methadone Measurement

C75348 Methamphetamine Methamphetamine A measurement of the Methamphetamine

methamphetamine drug present in Measurement
C14739 Methanol Methanol A measurement of the methanol in Methanol Measurement

C74882 Methaqualone Methaqualone A measurement of the Methaqualone

methaqualone present in a Measurement
C96689 Methemoglobin Methemoglobin A measurement of the Methemoglobin

methemoglobin in a biological Measurement
specimen.
C14736 Methemoglobin/Total FMET HB;Fractionated A relative measurement (ratio or Methemoglobin to Total

7 Hemoglobin Methemoglobin;Methemoglobin/Total percentage) of the amount of Hemoglobin Ratio
Hemoglobin methemoglobin compared to total Measurement
hemoglobin in a biological
specimen.
C12223 Methionine Methionine A measurement of the methionine Methionine Measurement

page 832 of 1925

C6715 LBTEST
4
Code Value
C96690 Methylmalonic Acid Methylmalonate;Methylmalonic Acid A measurement of the Methylmalonic Acid

methylmalonic acid in a biological Measurement
specimen.
C64822 Microcytes Microcytes A measurement of the microcytes Microcyte Count

C11784 Microfilaria Microfilaria Presence of microfilaria stage of Microfilaria Measurement

3 filarial nematodes in smears
prepared from whole blood or
other body fluids.
C11619 Mid Cell Fraction Mid Cell Fraction;Mid Cells A measurement of the mid cell Mid Cell Fraction
9 fraction, including eosinophils, Measurement
basophils, monocytes and other
precursor white blood cells, in a
C13908 Midazolam Midazolam A measurement of the midazolam Midazolam Measurement

C14739 Mitochondrial M2 Antibody Mitochondrial M2 Antibody A measurement of the Mitochondrial M2 Antibody

5 mitochondrial antibodies of M2 Measurement
specificity in a biological specimen.
C13010 Mixed Antigen IgE Mixed Antigen IgE Antibody A measurement of the mixed Mixed Antigen IgE
C74771 Mixed Casts Mixed Casts A measurement of the mixed (the Mixed Cast Count
cast contains a mixture of cell
types) casts present in a biological
specimen.
C16790 Mixed Lymphocyte Mixed Leukocyte Reaction;Mixed Lymphocyte A measurement of the Mixed Lymphocyte
Reaction Reaction histocompatibility at the HL-A Reaction Test
locus between two populations of
lymphocytes taken from two
separate individuals.
C13011 Mold Mix Antigen IgA Mold Mix Antigen IgA Antibody A measurement of the mold mix Mold Mix Antigen IgA
1 Antibody antigen IgA antibody in a Antibody Measurement
C13010 Mold Mix Antigen IgE Mold Mix Antigen IgE Antibody A measurement of the mold mix Mold Mix Antigen IgE
C13011 Mold Mix Antigen IgG Mold Mix Antigen IgG Antibody A measurement of the mold mix Mold Mix Antigen IgG
C74631 Monoblasts Monoblasts A measurement of the monoblast Monoblast Count

C74646 Monoblasts/Leukocytes Monoblasts/Leukocytes A relative measurement (ratio or Monoblast to Leukocyte

percentage) of the monoblasts to Ratio Measurement
specimen.
C92291 Monoclonal Protein Monoclonal Immunoglobulin Protein;Monoclonal A measurement of homogenous Monoclonal Protein
Protein;Paraprotein immunoglobulin resulting from the Measurement
proliferation of a single clone of
plasma cells in a biological
specimen.
C11784 Monoclonal Protein Spike Monoclonal Protein Spike A measurement of the monoclonal Monoclonal Protein Spike
4 protein in the region of the Measurement
electrophoresis field containing a
spike (increase) in protein.
C14739 Monoclonal Protein/Total Monoclonal Protein/Total Protein A relative measurement (ratio or Monoclonal Protein to
7 Protein percentage) of the monoclonal Total Protein Ratio
protein to total protein in a Measurement
C82025 Monocyte Chemotactic Monocyte Chemotactic Protein 1 A measurement of the monocyte Monocyte Chemotactic
Protein 1 chemotactic protein 1 in a Protein 1 Measurement
C64823 Monocytes Monocytes A measurement of the monocytes Monocyte Count

page 833 of 1925

C6715 LBTEST
4
Code Value
C14739 Monocytes and Monocytes and Macrophages/Leukocytes A relative measurement (ratio or Monocytes and
6 Macrophages/Leukocytes percentage) of the monocytes and Macrophages to
macrophages to total leukocytes in Leukocytes Ratio
C64824 Monocytes/Leukocytes Monocytes/Leukocytes A relative measurement (ratio or Monocyte to Leukocyte

percentage) of the monocytes to Ratio
specimen.
C10654 Monocytes/Macrocytes Monocytes/Macrocytes A relative measurement (ratio or Monocytes to Macrocytes

4 percentage) of the monocytes to Ratio Measurement
macrocytes present in a sample.
C13543 Monocytes/Non-Squam Epi Monocytes/Non-Squam Epi Cells A relative measurement (ratio or Monocytes to Non-
3 Cells percentage) of the monocytes to Squamous Epithelial Cells
C98872 Monocytes/Total Cells Monocytes/Total Cells A relative measurement (ratio or Monocytes to Total Cell
percentage) of the monocytes to Ratio Measurement
specimen).
C11127 Monocytoid Cells Monocytoid Cells A measurement of the monocytoid Monocytoid Cell Count
C12064 Monocytoid Monocytoid Cells/Leukocytes A relative measurement (ratio or Monocytoid Cells to

1 Cells/Leukocytes percentage) of the monocytoid Leukocytes Ratio
cells to leukocytes in a biological Measurement
specimen.
C11127 Monocytoid Cells/Total Monocytoid Cells/Total Cells A relative measurement (ratio or Monocytoid Cell to Total
7 Cells percentage) of the monocytoid Cell Ratio Measurement
cells to total cells in a biological
specimen.
C15475 Mononuclear Cells Mononuclear Cells;Mononucleated Cells A measurement of the Mononuclear Cell Count
7 mononuclear cells in a biological
specimen.
C74681 Monosodium Urate Monosodium Urate Crystals A measurement of the Monosodium Urate Crystal
Crystals monosodium urate crystals Measurement
C74883 Morphine Morphine A measurement of the morphine Morphine Measurement

C14743 Motile Sperm/Total Sperm Motile Sperm/Total Sperm A relative measurement (ratio or Motile Sperm to Total
3 percentage) of the motile sperm to Sperm Ratio Measurement
total sperm in a biological
specimen.
C79457 Mu Glutathione-S- Mu Glutathione-S-Transferase A measurement of the mu form of Mu Glutathione-S-

Transferase glutathione S-transferase in a Transferase Measurement
C79458 Mu Glutathione-S- Mu Glutathione-S-Transferase/Creatinine A relative measurement (ratio or Mu Glutathione-S-

Transferase/Creatinine percentage) of the mu gamma Transferase to Creatinine
glutamyl transpeptidase to Ratio Measurement
C13009 Mucor racemosus IgA Mucor racemosus IgA A measurement of the Mucor Mucor racemosus IgA
7 racemosus antigen IgA antibody in Measurement
C13009 Mucor racemosus IgE Mucor racemosus IgE A measurement of the Mucor Mucor racemosus IgE
6 racemosus antigen IgE antibody in Measurement
C13009 Mucor racemosus IgG Mucor racemosus IgG A measurement of the Mucor Mucor racemosus IgG
8 racemosus antigen IgG antibody in Measurement
C13009 Mucor racemosus IgG4 Mucor racemosus IgG4 A measurement of the Mucor Mucor racemosus IgG4
9 racemosus antigen IgG4 antibody Measurement
C74721 Mucous Threads Mucous Threads A measurement of the mucous Mucous Thread
threads present in a biological Measurement
specimen.
page 834 of 1925

C6715 LBTEST
4
Code Value
C12213 Mumps Virus IgG Antibody Mumps Virus IgG Antibody A measurement of the mumps Mumps Virus IgG Antibody
6 virus IgG antibody in a biological Measurement
specimen.
C12763 Murinoglobulin Murinoglobulin A measurement of the Murinoglobulin

0 murinoglobulin in a biological Measurement
specimen.
C12434 Mycobacterium Mycobacterium tuberculosis IgA Antibody A measurement of the Mycobacterium

6 tuberculosis IgA Antibody Mycobacterium tuberculosis IgA tuberculosis IgA Antibody
specimen.
C12434 Mycobacterium Mycobacterium tuberculosis IgE Antibody A measurement of the Mycobacterium

7 tuberculosis IgE Antibody Mycobacterium tuberculosis IgE tuberculosis IgE Antibody
specimen.
C12434 Mycobacterium Mycobacterium tuberculosis IgG Antibody A measurement of the Mycobacterium

8 tuberculosis IgG Antibody Mycobacterium tuberculosis IgG tuberculosis IgG Antibody
specimen.
C92279 Mycobacterium Mycobacterium tuberculosis Nucleic Acid A measurement of the Mycobacterium

tuberculosis Nucleic Acid Mycobacterium tuberculosis tuberculosis Nucleic Acid
nucleic acid in a biological Measurement
specimen.
C10341 Myelin Antibodies Myelin Antibodies A measurement of the myelin Myelin Antibodies
specimen.
C12213 Myelin Basic Protein Myelin Basic Protein A measurement of the myelin Myelin Basic Protein
5 basic protein in a biological Measurement
specimen.
C74632 Myeloblasts Myeloblasts A measurement of the myeloblast Myeloblast Count

C64825 Myeloblasts/Leukocytes Myeloblasts/Leukocytes A relative measurement (ratio or Myeloblast to Leukocyte

percentage) of the myeloblasts to Ratio
specimen.
C98761 Myeloblasts/Total Cells Myeloblasts/Total Cells A relative measurement (ratio or Myeloblast to Total Cell
percentage) of the myeloblasts to Ratio Measurement
specimen).
C74662 Myelocytes Myelocytes A measurement of the myelocytes Myelocyte Count

C64826 Myelocytes/Leukocytes Myelocytes/Leukocytes A relative measurement (ratio or Myelocyte to Leukocyte

percentage) of the myelocytes to Ratio
specimen.
C98868 Myelocytes/Total Cells Myelocytes/Total Cells A relative measurement (ratio or Myelocyte to Total Cell
percentage) of the myelocytes to Ratio Measurement
specimen).
C13543 Myeloid Maturation Index Myeloid Maturation Index A relative measurement (ratio) of Myeloid Maturation Index
4 the sum of myeloid maturation
myeloid proliferative phase cells
C13543 Myeloid Maturation Pool Myeloid Maturation Pool A measurement of the myeloid Myeloid Maturation Pool
5 maturation phase cells Count
(metamyelocytes, band
neutrophils, and segmented
neutrophils) in a biological
specimen.
C13016 Myeloid Progenitor Cells Myeloid Progenitor Cells A measurement of the myeloid Myeloid Progenitor Cell
5 progenitor cells in a biological Count
specimen.
page 835 of 1925

C6715 LBTEST
4
Code Value
C13543 Myeloid Proliferation Index Myeloid Proliferation Index A relative measurement (ratio) of Myeloid Proliferation Index
6 the sum of myeloid proliferative
myeloid maturation phase cells
C13543 Myeloid Proliferation Pool Myeloid Proliferation Pool A measurement of the myeloid Myeloid Proliferation Pool
7 proliferative phase cells Count
(myeloblasts, promyelocytes, and
myelocytes) in a biological
specimen.
C92242 Myeloid/Erythroid Ratio Myeloid/Erythroid Ratio A relative measurement of myeloid Myeloid to Erythroid Ratio
progenitor cells to erythrocyte Measurement
precursor cells in a biological
specimen.
C80198 Myeloperoxidase Myeloperoxidase A measurement of the Myeloperoxidase

myeloperoxidase in a biological Measurement
specimen.
C92280 Myeloperoxidase Antibody Myeloperoxidase Antibody A measurement of the Myeloperoxidase Antibody

myeloperoxidase antibody in a Measurement
C11929 Myeloperoxidase Index Myeloperoxidase Index The mean peroxidase activity Neutrophil
0 index or staining intensity of the Myeloperoxidase Index
neutrophil population relative to
the archetype.
C79436 Myoglobin Myoglobin A measurement of myoglobin in a Myoglobin Measurement

C10654 Myoglobin/Creatinine Myoglobin/Creatinine A relative measurement (ratio or Myoglobin to Creatinine

6 percentage) of the myoglobin to Ratio Measurement
C10654 Myosin Light Chain 3 Cardiac myosin light chain 1;Myosin Light Chain A measurement of myosin light Myosin Light Chain 3
7 3;Myosin light chain 1, slow-twitch muscle chain 3 in a biological specimen. Measurement
B/ventricular isoform
C79459 N-Acetyl Glucosamide N-Acetyl Glucosamide;N-Acetyl Glucosamine A measurement of N-acetyl N-Acetyl Glucosamide
glucosamide (sugar derivative) in Measurement
C79460 N-Acetyl N-Acetyl Glucosamide/Creatinine A relative measurement (ratio or N-Acetyl Glucosamide to

Glucosamide/Creatinine percentage) of the N-acetyl Creatinine Ratio
glucosamide to creatinine in a Measurement
C10341 N-acetyl-beta-D- Beta-N-acetyl-D-glucosaminidase;N-acetyl-beta- A measurement of the N-acetyl- N-acetyl-beta-D-

9 glucosaminidase D-glucosaminidase beta-D-glucosaminidase (enzyme) glucosaminidase
C14740 N-methylhistamine N-methylhistamine A measurement of the N- N-methylhistamine

4 methylhistamine in a biological Measurement
specimen.
C74743 N-telopeptide N-telopeptide A measurement of the N- N-Telopeptide

telopeptide in a biological Measurement
specimen.
C12064 N-telopeptide/Creatinine N-telopeptide/Creatinine A relative measurement (ratio or N-telopeptide to Creatinine

5 percentage) of the N-telopeptide Ratio Measurement
to creatinine in a biological
specimen.
C13908 N-Terminal ProA-type N-Terminal ProA-type Natriuretic Peptide;N- A measurement of the N-terminal N-Terminal ProA-type
8 Natriuretic Peptide terminal pro-Atrial Natriuretic Peptide;NT proANP proA-type natriuretic peptide in a Natriuretic Peptide
II biological specimen. Measurement
C96610 N-Terminal ProB-type N-Terminal ProB-type Natriuretic Peptide;N- A measurement of the N-terminal N-Terminal ProB-type
Natriuretic Peptide terminal pro-Brain Natriuretic Peptide;NT proBNP proB-type natriuretic peptide in a Natriuretic Peptide
II biological specimen. Measurement
C11620 Natural Killer Cell Function Natural Killer Cell Activity;Natural Killer Cell A measurement of the natural Natural Killer Cell Activity
3 Function killer cell function in a biological Measurement
specimen.
C98762 Natural Killer Cells Natural Killer Cells A measurement of the total Natural Killer Cell Count
natural killer cells in a biological
specimen.
page 836 of 1925

C6715 LBTEST
4
Code Value
C92298 Neisseria gonorrhoeae Neisseria gonorrhoeae Screening Examination of a biological Neisseria gonorrhoeae
Screening specimen to detect the presence Screening
of Neisseria gonorrhoeae.
C80199 Neopterin Neopterin A measurement of the neopterin in Neopterin Measurement

C13543 Nerve Growth Factor Nerve Growth Factor A measurement of the nerve Nerve Growth Factor
9 growth factor in a biological Measurement
specimen.
C14228 Neurofilament Light Chain Neurofilament Light Chain Protein;Neurofilament A measurement of the Neurofilament Light Chain
5 Protein Light Polypeptide;Protein Phosphatase 1, neurofilament light chain protein Protein Measurement
Regulatory Subunit 110 in a biological specimen.
C11620 Neuron Specific Enolase Enolase 2;Gamma-enolase;Neuron Specific A measurement of the neuron Neuron Specific Enolase
5 Enolase specific enolase in a biological Measurement
specimen.
C74892 Neuropeptide Y Neuropeptide Y A measurement of the Neuropeptide Y

neuropeptide Y in a biological Measurement
specimen.
C14740 Neutral Fats Neutral Fats A measurement of the total Neutral Fats Measurement
7 neutral fats in a biological
specimen.
C14730 Neutrophil Cytoplasmic Ab, Anti-Neutrophil Cytoplasmic Antibody, A measurement of the atypical Atypical Neutrophil
0 Atypical Atypical;Neutrophil Cytoplasmic Ab, Atypical (cytoplasmic staining usually Cytoplasmic Antibody
uniform and no interlobular Measurement
accentuation) neutrophil
cytoplasmic antibodies in a
C14730 Neutrophil Cytoplasmic Ab, Anti-Neutrophil Cytoplasmic Antibody, A measurement of the classic Classic Neutrophil
1 Classic Classic;Neutrophil Cytoplasmic Ab, Classic (cytoplasmic granular fluorescence Cytoplasmic Antibody
with central interlobular Measurement
accentuation) neutrophil
C14730 Neutrophil Cytoplasmic Ab, Anti-Neutrophil Cytoplasmic Antibody, A measurement of the perinuclear Perinuclear Neutrophil
2 Perinuclear Perinuclear;Neutrophil Cytoplasmic Ab, (perinuclear staining without Cytoplasmic Antibody
Perinuclear nuclear extension) neutrophil Measurement
C82026 Neutrophil Elastase Neutrophil Elastase A measurement of the neutrophil Neutrophil Elastase
elastase in a biological specimen. Measurement
C82027 Neutrophil Elastase, Neutrophil Elastase, Polymorphonuclear A measurement of the Polymorphonuclear

Polymorphonuclear polymorphonuclear neutrophil Neutrophil Elastase
elastase in a biological specimen. Measurement
C84822 Neutrophilic Neutrophilic Metamyelocytes A measurement of the neutrophilic Neutrophilic

Metamyelocytes metamyelocytes in a biological Metamyelocyte Count
specimen.
C84823 Neutrophilic Myelocytes Neutrophilic Myelocytes A measurement of the neutrophilic Neutrophilic Myelocyte
myelocytes in a biological Count
specimen.
C13237 Neutrophilic Toxic Change Neutrophilic Toxic Change A measurement of any type of Neutrophilic Toxic Change
6 toxic change in cells of the Assessment
neutrophilic lineage in a biological
specimen.
C63321 Neutrophils Neutrophils A measurement of the neutrophils Absolute Neutrophil Count

C64830 Neutrophils Band Form Neutrophils Band Form A measurement of the banded Neutrophil Band Form
neutrophils in a biological Count
specimen.
C12064 Neutrophils Band Form/ Neutrophils Band Form/ Neutrophils A relative measurement (ratio or Neutrophils Band Form to
2 Neutrophils percentage) of banded neutrophils Neutrophils Ratio
to total neutrophils in a biological Measurement
specimen.
C64831 Neutrophils Band Neutrophils Band Form/Leukocytes A relative measurement (ratio or Neutrophil Band Form to
Form/Leukocytes percentage) of the banded Leukocyte Ratio
neutrophils to leukocytes in a
page 837 of 1925

C6715 LBTEST
4
Code Value
C15475 Neutrophils, Seg + Band Neutrophils, Seg + Band Form + A measurement of the segmented Segmented, Band Form
6 Form + Precursor Precursor;Neutrophils, Segmented + Band Form and band form neutrophils, and Precursor Neutrophils
+ Precursors metamyelocytes, myelocytes, Measurement
promyelocytes, and myeloblasts in
C81997 Neutrophils, Segmented Neutrophils, Segmented A measurement of the segmented Segmented Neutrophil
neutrophils in a biological Count
specimen.
C15475 Neutrophils, Segmented + Neutrophils, Segmented + Band Form A measurement of the segmented Segmented and Band
5 Band Form and band form neutrophils in a Form Neutrophils
C82045 Neutrophils, Neutrophils, Segmented/Leukocytes A relative measurement (ratio or Segmented Neutrophil to

Segmented/Leukocytes percentage) of segmented Leukocyte Ratio
neutrophils to leukocytes in a Measurement
C12064 Neutrophils, Neutrophils, Segmented/Neutrophils A relative measurement (ratio or Segmented Neutrophils to

3 Segmented/Neutrophils percentage) of segmented Neutrophils Ratio
neutrophils to total neutrophils in Measurement
C64827 Neutrophils/Leukocytes Neutrophils/Leukocytes A relative measurement (ratio or Neutrophil to Leukocyte

percentage) of the neutrophils to Ratio
specimen.
C13543 Neutrophils/Non-Squam Neutrophils/Non-Squam Epi Cells A relative measurement (ratio or Neutrophils to Non-
8 Epi Cells percentage) of the neutrophils to Squamous Epithelial Cells
C98763 Neutrophils/Total Cells Neutrophils/Total Cells A relative measurement (ratio or Neutrophil to Total Cell
percentage) of the neutrophils to Ratio Measurement
specimen).
C74899 Niacin Niacin;Vitamin B3 A measurement of the niacin in a Vitamin B3 Measurement

C14740 Nicotine Nicotine A measurement of the nicotine in Nicotine Measurement

C11236 Nitric Oxide NO;Nitric Oxide A measurement of the nitric oxide Nitric Oxide Measurement
C64810 Nitrite Nitrite A measurement of the nitrite in a Nitrite Measurement

C15474 Nociceptin Nociceptin;Orphanin FQ A measurement of the nociceptin Nociceptin Measurement

C11620 Non-HDL Cholesterol Non-HDL Cholesterol;Non-High Density A measurement of the non-high Non-High Density
4 Lipoprotein density lipoprotein cholesterol in a Lipoprotein Cholesterol
C12064 Non-HDL Cholesterol/HDL Non-HDL Cholesterol/HDL Cholesterol A relative measurement (ratio or Non-HDL Cholesterol to
4 Cholesterol percentage) of non-high density HDL Cholesterol Ratio
lipoprotein cholesterol to high Measurement
density lipoprotein cholesterol in a
C84811 Non-Phosphorylated Tau Non-Phosphorylated Tau Protein A measurement of the non- Nonphosphorylated Tau
Protein phosphorylated Tau protein in a Protein Measurement
C10043 Non-Prostatic Acid Non-Prostatic Acid Phosphatase A measurement of the non- Non-Prostatic Acid
4 Phosphatase prostatic acid phosphatase in a Phosphatase Measurement
C13541 Non-Squamous Epithelial Non-Squamous Epithelial Cells A measurement of the non- Non-Squamous Epithelial
3 Cells squamous epithelial cells in a Cell Count
C14740 Nonhematic Cells Nonhematic Cells A measurement of the cells of Nonhematic Cells Count
1 nonhematopoietic origin in a
page 838 of 1925

C6715 LBTEST
4
Code Value
C14740 Nonhematic Nonhematic Cells/Leukocytes A relative measurement (ratio) of Nonhematic Cells to

2 Cells/Leukocytes the nonhematic cells to total Leukocytes Ratio
leukocytes in a biological Measurement
specimen.
C13907 Nordazepam Nordazepam;Nordiazepam A measurement of the Nordazepam Measurement

6 nordazepam present in a biological
specimen.
C74868 Norepinephrine Noradrenaline;Norepinephrine A measurement of the Noradrenaline

norepinephrine hormone in a Measurement
C14228 Normal Sperm/Total Normal Sperm/Total Sperm;Sperm Morphology A measurement (ratio or Normal Sperm to Total
6 Sperm percentage) of the normal Sperm Ratio Measurement
spermatozoa to total spermatozoa
C12213 Normetanephrine Normetanephrine A measurement of the Normetanephrine

8 normetanephrine in a biological Measurement
specimen.
C98764 Normoblasts/Total Cells Normoblasts/Total Cells A relative measurement (ratio or Normoblast to Total Cell
percentage) of the normoblasts to Ratio Measurement
specimen).
C14740 Nornicotine Nornicotine A measurement of the nornicotine Nornicotine Measurement

C11421 Nuclear Swelling Nuclear Swelling A measurement of the expansion Nuclear Swelling
3 of the nucleus of the cells in a Measurement
C15084 Nucleated Cells Nucleated Cells A measurement of the nucleated Nucleated Cell Count
C74705 Nucleated Erythrocytes Nucleated Erythrocytes;Nucleated Red Blood A measurement of the nucleated Nucleated Red Blood Cell
Cells erythrocytes (large, immature Count
nucleated erythrocytes) in a
C74647 Nucleated Nucleated Erythrocytes/Erythrocytes;Nucleated A relative measurement (ratio or Nucleated Red Blood Cell
Erythrocytes/Erythrocytes Red Blood Cells/Erythrocytes percentage) of the nucleated to Erythrocyte Ratio
erythrocytes (large, immature Measurement
nucleated erythrocytes) to all
specimen.
C82046 Nucleated Nucleated Erythrocytes/Leukocytes A relative measurement (ratio or Nucleated Erythrocyte to

Erythrocytes/Leukocytes percentage) of nucleated Leukocyte Ratio
erythrocytes to leukocytes in a Measurement
C13012 Nut Mix Antigen IgE Nut Mix Antigen IgE Antibody A measurement of the nut mix Nut Mix Antigen IgE
C13012 Nut Mix Antigen IgG Nut Mix Antigen IgG Antibody A measurement of the nut mix Nut Mix Antigen IgG
C74686 Occult Blood Occult Blood A measurement of the blood in Occult Blood Measurement
body products such as a urine or
stool sample, not detectable on
gross examination.
C12213 Oligoclonal Bands Oligoclonal Bands A measurement of the oligoclonal Oligoclonal Bands
9 bands in a biological specimen. Measurement
C13237 Oncostatin M Oncostatin M A measurement of the oncostatin Oncostatin M

7 M in a biological specimen. Measurement
C74796 Opiate Opiate A measurement of any opiate class Opiate Measurement

drug present in a biological
specimen.
C13008 Orchard Grass Pollen IgA Cocksfoot Grass Pollen IgA;Orchard Grass Pollen A measurement of the Dactylis Orchard Grass Pollen IgA
1 IgA glomerata pollen antigen IgA Measurement
page 839 of 1925

C6715 LBTEST
4
Code Value
C13008 Orchard Grass Pollen IgE Cocksfoot Grass Pollen IgE;Orchard Grass Pollen A measurement of the Dactylis Orchard Grass Pollen IgE
0 IgE glomerata pollen antigen IgE Measurement
C13008 Orchard Grass Pollen IgG Cocksfoot Grass Pollen IgG;Orchard Grass Pollen A measurement of the Dactylis Orchard Grass Pollen IgG
2 IgG glomerata pollen antigen IgG Measurement
C13008 Orchard Grass Pollen IgG4 Cocksfoot Grass Pollen IgG4;Orchard Grass A measurement of the Dactylis Orchard Grass Pollen IgG4
3 Pollen IgG4 glomerata pollen antigen IgG4 Measurement
C12214 Ornithine Ornithine A measurement of the ornithine in Ornithine Measurement

C74801 Osmolality Osmolality A measurement of the osmoles of Osmolality Measurement

solute per unit of biological
specimen.
C74802 Osmolarity Osmolarity A measurement of the osmoles of Osmolarity Measurement

solute per liter of solution.
C74744 Osteocalcin Osteocalcin A measurement of the osteocalcin Osteocalcin Measurement

C12434 Osteopontin Osteopontin A measurement of the osteopontin Osteopontin Measurement

C11620 Osteoprotegerin OCIF;Osteoclastogenesis Inhibitory A measurement of the Osteoprotegerin

6 Factor;Osteoprotegerin;TNFRS11B;Tumor osteoprotegerin in a biological Measurement
Necrosis Factor Receptor Superfamily Member specimen.
11b
C10045 Ova and Parasite Ova and Parasite A measurement of the parasites Ova and Parasite
2 and ova in a biological specimen. Measurement
C14228 Ovalocytes Ovalocytes A measurement of the ovalocytes Ovalocyte Count

7 (oval shaped cell with rounded
ends and a long axis less than
twice its short axis) in a biological
specimen.
C92250 Oxalate Ethanedioate;Oxalate A measurement of the oxalate in a Oxalate Measurement

C11798 Oxalate/Creatinine Oxalate/Creatinine A relative measurement (ratio or Oxalate to Creatinine Ratio

3 percentage) of the oxalate to Measurement
C75375 Oxazepam Oxazepam A measurement of the oxazepam Oxazepam Measurement

C12063 Oxidized LDL Cholesterol Oxidized LDL Cholesterol A measurement of the oxidized Oxidized LDL Cholesterol
5 low density lipoprotein cholesterol Measurement
C11928 Oxidized LDL Cholesterol Oxidized LDL Cholesterol Antibody A measurement of the total Oxidized LDL Cholesterol
8 Antibody oxidized low density lipoprotein Antibody Measurement
cholesterol antibody in a biological
specimen.
C74884 Oxycodone Oxycodone;Oxycontin A measurement of the oxycodone Oxycodone Measurement

C96614 Oxygen Capacity Oxygen Capacity A measurement of the maximum Oxygen Capacity
amount of oxygen that can be Measurement
combined chemically with
hemoglobin in a volume of blood.
C11128 Oxygen Content Oxygen Content A measurement of the amount of Oxygen Measurement
4 oxygen content in a biological
specimen.
C60832 Oxygen Saturation Oxygen Saturation A measurement of the oxygen- Oxygen Saturation
hemoglobin saturation of a volume Measurement
of blood.
C96616 Oxyhemoglobin Oxyhemoglobin A measurement of the Oxyhemoglobin

oxyhemoglobin, oxygen-bound Measurement
hemoglobin, in a biological
specimen.
page 840 of 1925

C6715 LBTEST
4
Code Value
C14735 Oxyhemoglobin/Total FO2 Hb;Fractioned A relative measurement (ratio or Oxyhemoglobin to Total

9 Hemoglobin Oxyhemoglobin;Oxyhemoglobin/Total percentage) of the amount of Hemoglobin Ratio
Hemoglobin oxyhemoglobin compared to total Measurement
hemoglobin in a biological
specimen.
C14740 Oxymorphone Oxymorphone A measurement of the Oxymorphone

9 Oxymorphone in a biological Measurement
specimen.
C74869 Oxytocin Oxytocin;Oxytoxin A measurement of the oxytocin Oxytocin Measurement

C12763 P-Aminohippurate Sodium P-Aminohippurate Sodium A measure of the para- Para-Aminohippurate

1 aminohippurate sodium in a Sodium Measurement
C11785 P-Selectin GMP-140;P-Selectin A measurement of total P-selectin P-Selectin Measurement

C13014 P. notatum Antigen IgA P. notatum Antigen IgA Antibody A measurement of the Penicillium Penicillium notatum
7 Antibody notatum antigen IgA antibody in a Antigen IgA Antibody
C13014 P. notatum Antigen IgE P. notatum Antigen IgE Antibody A measurement of the Penicillium Penicillium notatum
6 Antibody notatum antigen IgE antibody in a Antigen IgE Antibody
C13014 P. notatum Antigen IgG P. notatum Antigen IgG Antibody A measurement of the Penicillium Penicillium notatum
8 Antibody notatum antigen IgG antibody in a Antigen IgG Antibody
C13014 P. notatum Antigen IgG4 P. notatum Antigen IgG4 Antibody A measurement of the Penicillium Penicillium notatum
9 Antibody notatum antigen IgG4 antibody in Antigen IgG4 Antibody
C12065 P100 Polymyositis- P100 Polymyositis-scleroderma Autoag Ab A measurement of the p100 P100 Polymyositis-
1 scleroderma Autoag Ab polymyositis-scleroderma overlap scleroderma Autoantigen
syndrome-associated autoantigen Antibody Measurement
C10227 P50 Oxygen P50 Oxygen A measurement of the partial P50 Oxygen Measurement
9 pressure of oxygen when
hemoglobin is half saturated in a
C82028 Pancreatic Elastase 1 Pancreatic Elastase 1 A measurement of the pancreatic Pancreatic Elastase
elastase 1 in a biological Measurement
specimen.
C82029 Pancreatic Elastase 1, Pancreatic Elastase 1, Polymorphonuclear A measurement of the Polymorphonuclear

Polymorphonuclear polymorphonuclear pancreatic Pancreatic Elastase
elastase 1 in a biological Measurement
specimen.
C80201 Pancreatic Polypeptide Pancreatic Polypeptide A measurement of the pancreatic Pancreatic Polypeptide
polypeptide in a biological Measurement
specimen.
C11621 Panel Reactive Antibody PRA Score;Panel Reactive Antibody;Percent A measurement of the panel Panel Reactive Antibody
0 Reactive Antibody reactive antibody that is achieved Test
by mixing and assessing the
reactivity between the recipient's
immune cells and the donor's
human leukocyte antigen, in which
anti-HLA class I and class II
antibody specificities are
measured separately in a
C74616 Pappenheimer Bodies Pappenheimer Bodies A measurement of the cells Pappenheimer Body Count
containing Pappenheimer Bodies
(violet or blue staining ferritin
granules usually found along the
periphery of the red blood cells) in
C81964 Parathyroid Hormone, C- Parathyrin Hormone, C-Terminal;Parathyroid A measurement of the C-terminal C-Terminal Parathyroid
Terminal Hormone, C-Terminal fragment of parathyroid hormone Hormone Measurement
page 841 of 1925

C6715 LBTEST
4
Code Value
C74784 Parathyroid Hormone, Parathyrin Hormone, Fragmented;Parathyroid A measurement of the fragmented Fragmented Parathyroid
Fragmented Hormone, Fragmented parathyroid hormone in a Hormone Measurement
C74789 Parathyroid Hormone, Parathyrin, Intact;Parathyroid Hormone, Intact A measurement of the intact Intact Parathyroid
Intact parathyroid hormone (consisting Hormone Measurement
of amino acids 1-84 or 7-84) in a
C81965 Parathyroid Hormone, Mid- Parathyrin Hormone, Mid-Molecule;Parathyroid A measurement of the mid- Mid-Molecule Parathyroid
Molecule Hormone, Mid-Molecule molecule fragment of parathyroid Hormone Measurement
C81966 Parathyroid Hormone, N- Parathyrin Hormone, N-Terminal;Parathyroid A measurement of the N-terminal N-Terminal Parathyroid
Terminal Hormone, N-Terminal fragment of parathyroid hormone Hormone Measurement
C10345 Parathyroid Hormone, Parathyrin Hormone, Whole;Parathyroid A measurement of the whole Whole Parathyroid
1 Whole Hormone, Whole parathyroid hormone (consisting Hormone Measurement
of amino acids 1-84) in a biological
specimen.
C11785 Parathyroid Hormone- Parathyrin Hormone-related Protein;Parathyroid A measurement of parathyroid Parathyroid Hormone-
1 related Protein Hormone-related Peptide;Parathyroid Hormone- hormone-related protein in a related Protein
related Protein biological specimen. Measurement
C11620 Parietal Cell Antibody Anti-Parietal Cell Antibody;Parietal Cell Antibody A measurement of the parietal cell Parietal Cell Antibody
C14741 Paroxetine Paroxetine A measurement of the paroxetine Paroxetine Measurement

C82625 Partial Pressure Carbon Partial Pressure Carbon Dioxide A measurement of the pressure of Partial Pressure of Carbon
Dioxide carbon dioxide in a biological Dioxide Measurement
specimen.
C14741 Partial Pressure Carbon Partial Pressure Carbon Dioxide Adj Temp A measurement of the pressure of Partial Pressure of Carbon
1 Dioxide Adj Temp carbon dioxide, which has been Dioxide Adjusted for Body
adjusted for body temperature, in Temperature Measurement
C71251 Partial Pressure Oxygen Partial Pressure Oxygen A measurement of the pressure of Partial Pressure of Oxygen
oxygen in a biological specimen. Measurement
C14741 Partial Pressure Oxygen Partial Pressure Oxygen Adj for Temp A measurement of the pressure of Partial Pressure of Oxygen
7 Adj for Temp oxygen, which has been adjusted Adjusted for Body
for body temperature, in a Temperature Measurement
C96617 Parvovirus B19 IgG Parvovirus B19 IgG Antibody A measurement of the Parvovirus Parvovirus B19 IgG
Antibody B19 IgG antibody in a biological Antibody Measurement
specimen.
C96618 Parvovirus B19 IgM Parvovirus B19 IgM Antibody A measurement of the Parvovirus Parvovirus B19 IgM
Antibody B19 IgM antibody in a biological Antibody Measurement
specimen.
C13237 PCA3 mRNA/PSA mRNA PCA3 mRNA/PSA mRNA A relative measurement (ratio) of PCA3 mRNA to PSA mRNA
8 the prostate cancer antigen 3 Ratio Measurement
mRNA to prostate specific antigen
mRNA in a biological specimen.
C74617 Pelger Huet Anomaly Pelger Huet Anomaly A measurement of the Pelger Huet Pelger Huet Anomaly
Anomaly (nuclei of neutrophils and Measurement
eosinophils appear rod-like,
spherical or dumbbell shaped) in a
C81988 Pemphigoid Antibodies Pemphigoid Antibodies A measurement of the pemphigoid Pemphigoid Antibody
specimen.
C14728 Penicillium chrysogenum Penicillium chrysogenum IgE Antibody A measurement of the Penicillium Penicillium chrysogenum
7 IgE Antibody chrysogenum antigen IgE antibody IgE Antibody Measurement
C75367 Pentobarbital Pentobarbital A measurement of the Pentobarbital

pentobarbital present in a Measurement
C10012 Pepsinogen Pepsinogen A measurement of the pepsinogen Pepsinogen Measurement

page 842 of 1925

C6715 LBTEST
4
Code Value
C10046 Pepsinogen A PGA;Pepsinogen A A measurement of the pepsinogen Pepsinogen A

9 A in a biological specimen. Measurement
C10047 Pepsinogen C PGC;Pepsinogen C A measurement of the pepsinogen Pepsinogen C

0 C in a biological specimen. Measurement
C10046 Pepsinogen I PGI;Pepsinogen I A measurement of the pepsinogen Pepsinogen I Measurement

7 I in a biological specimen.
C10046 Pepsinogen II PGII;Pepsinogen II A measurement of the pepsinogen Pepsinogen II

8 II in a biological specimen. Measurement
C80202 Peptide YY Peptide Tyrosine Tyrosine;Peptide YY A measurement of the peptide YY Peptide YY Measurement
C11239 Periostin OSF2;Osteoblast Specific Factor A measurement of the periostin in Periostin Measurement
5 2;POSTN;Periostin a biological specimen.
C45997 pH pH The negative logarithm (base 10) pH

of the concentration of hydronium
ions, which is used as a measure
of the acidity or alkalinity of a
fluid.
C74694 Phencyclidine Phencyclidine;Phenylcyclohexylpiperidine A measurement of the Phencyclidine

phencyclidine present in a Measurement
C75368 Phenobarbital Phenobarbital A measurement of the Phenobarbital

phenobarbital present in a Measurement
C74695 Phenothiazine Dibenzothiazine;Phenothiazine A measurement of the Phenothiazine

phenothiazine present in a Measurement
C81280 Phenylalanine Phenylalanine A measurement of the Phenylalanine

phenylalanine in a biological Measurement
specimen.
C14741 Phenylketones Phenyl Ketones;Phenylketones A measurement of the total Phenylketone

4 phenylketones in a biological Measurement
specimen
C14741 Phenytoin Phenytoin A measurement of the phenytoin Phenytoin Measurement

C64857 Phosphate Inorganic Phosphate;Phosphate;Phosphorus A measurement of the phosphate Phosphate Measurement

C10655 Phosphate Clearance Phosphate Clearance A measurement of the volume of Phosphate Clearance
cleared of phosphate by excretion
(e.g. one minute).
C79461 Phosphate/Creatinine Phosphate/Creatinine A relative measurement (ratio or Phosphate to Creatinine

percentage) of the phosphate to Ratio Measurement
C14742 Phosphatidylcholine/Album Phosphatidylcholine/Albumin A relative measurement (ratio or Phosphatidylcholine to

0 in percentage) of the Albumin Ratio
phosphatidylcholine to albumin in Measurement
C14742 Phosphatidylglycerol/Lung Phosphatidylglycerol/Lung A relative measurement (ratio) of Phosphatidylglycerol to

3 Surfactant Surfactant;Phosphatidylglycerol/Pulmonary the phosphatidylglycerol to total Lung Surfactant Ratio
Surfactant lung surfactant in a biological Measurement
specimen.
C12214 Phosphatidylserine IgA Phosphatidylserine IgA Antibody A measurement of the Phosphatidylserine

3 Antibody phosphatidylserine IgA antibody in Antibody IgA
C12214 Phosphatidylserine IgG Phosphatidylserine IgG Antibody A measurement of the Phosphatidylserine

4 Antibody phosphatidylserine IgG antibody in Antibody IgG
C12214 Phosphatidylserine IgM Phosphatidylserine IgM Antibody A measurement of the Phosphatidylserine

5 Antibody phosphatidylserine IgM antibody in Antibody IgM
page 843 of 1925

C6715 LBTEST
4
Code Value
C96623 Phospholipid Phospholipid A measurement of the Phospholipid Measurement

phospholipids in a biological
specimen.
C15082 Phosphorus Excretion Rate Phosphorus Excretion Rate A measurement of the amount of Phosphorus Excretion Rate
1 phosphorus being excreted in a
C84812 Phosphorylated Tau Phosphorylated Tau Protein A measurement of the Phosphorylated Tau
Protein phosphorylated Tau protein in a Protein Measurement
C11927 Pi-GST Excretion Rate Pi-GST Excretion Rate A measurement of the amount of Pi-GST Excretion Rate
9 Pi Glutathione-S-Transferase being
excreted in a biological specimen
over a defined period of time (e.g.
one hour).
C74618 Plasmacytoid Lymphocytes Plasmacytoid Lymphocytes;Plymphocytes A measurement of the Plasmacytoid Lymphocyte

plasmacytoid lymphocytes Count
(lymphocytes with peripherally
clumped chromatin and often deep
blue cytoplasm, and that appear
similar to plasma cells) in a
C74648 Plasmacytoid Plasmacytoid Lymphocytes/Lymphocytes A relative measurement (ratio or Plasmacytoid Lymphocyte

Lymphocytes/Lymphocytes percentage) of the plasmacytoid to Lymphocyte Ratio
lymphocytes (lymphocytes with Measurement
peripherally clumped chromatin
and often deep blue cytoplasm,
and that appear similar to plasma
cells) to all lymphocytes in a
C12763 Plasminogen Plasminogen A measurement of the Plasminogen Measurement

3 plasminogen (antigen) in a
C82030 Plasminogen Activator Plasminogen Activator Inhibitor-1 A measurement of the Plasminogen Activator
Inhibitor-1 plasminogen activator inhibitor-1 Inhibitor-1 Measurement
C81989 Plasminogen Activator Plasminogen Activator Inhibitor-1 AG A measurement of the Plasminogen Activator
Inhibitor-1 AG plasminogen activator inhibitor-1 Inhibitor-1 Antigen
antigen in a biological specimen. Measurement
C10045 Plasmodium Malaria;Plasmodium Examination of a biological Plasmodium Measurement

3 specimen to detect the presence
of any protozoan belonging to the
Plasmodium genus.
C11129 Platelet Activating Factor Platelet Activating Factor A measurement of the platelet Platelet Activating Factor
2 activating factor in a biological Measurement
specimen.
C10342 Platelet Aggregation Platelet Aggregation;Platelet Function A measurement of the association Platelet Aggregation
7 of platelets to one another via Measurement
adhesion molecules in a biological
sample.
C11129 Platelet Aggregation Platelet Aggregation Amplitude A measurement of the magnitude Platelet Aggregation
3 Amplitude of the platelet aggregation in a Amplitude Measurement
C11421 Platelet Aggregation Curve Platelet Aggregation Curve Type The classification of the curve Platelet Aggregometry
0 Type pattern that is formed as a result Curve Type
of platelet aggregation.
C11421 Platelet Aggregation Mean Platelet Aggregation Mean Amplitude An average of the measurements Platelet Aggregometry
1 Amplitude of the magnitude of the platelet Mean Amplitude
aggregation in a biological
specimen.
C11421 Platelet Aggregation Mean Platelet Aggregation Mean Curve Type The classification of the curve Platelet Aggregometry
2 Curve Type pattern that is formed as the Mean Curve Type
average result of the platelet
aggregation curve measurements.
C96624 Platelet Clumps PLT Clumps;Platelet Clumps A measurement of the platelet Platelet Clumps Count
clumps in a biological specimen.
page 844 of 1925

C6715 LBTEST
4
Code Value
C11129 Platelet Component Platelet Component Distribution Width A measurement of a marker of Platelet Component
4 Distribution Width platelet shape change in a Distribution Width
C11620 Platelet Derived Growth PDGF Isoform AB;Platelet Derived Growth Factor A measurement of the platelet Platelet Derived Growth
8 Factor IsoformAB IsoformAB;Platelet Derived Growth Factor-AB derived growth factor isoform AB Factor Isoform AB
Isoform in a biological specimen. Measurement
C81962 Platelet Distribution Width Platelet Distribution Width A measurement of the range of Platelet Distribution Width
platelet sizes in a biological
specimen.
C14741 Platelet Fctr 4 Heparin Platelet Factor 4 Heparin Complex Induced A measurement of the platelet Platelet Factor 4-Heparin
2 Cmplx Induced Ab Antibody;Platelet Fctr 4 Heparin Cmplx Induced factor 4 heparin complex induced Complex Induced Antibody
Ab antibody in a biological specimen. Measurement
C11129 Platelet Function Closure PFCT;Platelet Function Closure Time A measurement of the platelet Platelet Function Closure
5 Time function closure time in a Time Measurement
C10042 Platelet Hematocrit Platelet Hematocrit;Thrombocytocrit A relative measurement (ratio or Platelet Hematocrit
4 percentage) of the proportion of Measurement
the volume of blood taken up by
platelets.
C13238 Platelet Mass Distribution Platelet Mass Distribution Width A measurement which represents Platelet Mass Distribution
0 Width the variation defined by two Width
standard deviations of the platelet
dry mass distribution in a
C11129 Platelet Morphology Platelet Morphology An examination or assessment of Platelet Morphology

6 the form and structure of Measurement
platelets.
C11620 Platelet Satellitism Platelet Satellitism An examination or assessment of Platelet Satellitism

9 the platelet satellitism (platelet Assessment
rosetting around cells) in a
C51951 Platelets Platelets A measurement of the platelets Platelet Count

(non-nucleated thrombocytes) in a
C14741 Platelets, Agranular Platelets, Agranular A measurement of the agranular Agranular Platelets Count
5 platelets in a biological specimen.
C13544 Platelets, Estimated Platelets, Estimated An estimated measurement of the Estimated Platelets
0 platelets (non-nucleated Measurement
thrombocytes) in a biological
specimen.
C79602 Poikilocytes Poikilocytes A measurement of the odd-shaped Poikilocyte Measurement

erythrocytes in a whole blood
specimen.
C74649 Poikilocytes/Erythrocytes Poikilocytes/Erythrocytes A relative measurement (ratio or Poikilocyte to Erythrocyte

percentage) of the poikilocytes, or Ratio Measurement
irregularly shaped erythrocytes, to
all erythrocytes in a biological
specimen.
C64803 Polychromasia Polychromasia A measurement of the blue- Polychromasia

staining characteristic of newly
generated erythrocytes.
C14741 Polychromatophilic Polychromatophilic Erythroblast A measurement of the Polychromatophilic

8 Erythroblast polychromatophilic erythroblasts in Erythroblast Count
a biological specimen taken from a
non-human organism.
C14741 Polychromatophilic Polychromatophilic Normoblast A measurement of the Polychromatophilic

9 Normoblast polychromatophilic normoblasts in Normoblast Count
a biological specimen taken from a
non-human organism.
C12064 Porphyrin Porphyrin A measurement of the total Porphyrin Measurement

8 porphyrin in a biological specimen.
C64853 Potassium Potassium A measurement of the potassium Potassium Measurement

page 845 of 1925

C6715 LBTEST
4
Code Value
C10656 Potassium Clearance Potassium Clearance A measurement of the volume of Potassium Clearance
cleared of potassium by excretion
(e.g. one minute).
C15082 Potassium Excretion Rate Potassium Excretion Rate A measurement of the amount of Potassium Excretion Rate
0 potassium being excreted in a
C79462 Potassium/Creatinine Potassium/Creatinine A relative measurement (ratio or Potassium to Creatinine

percentage) of the potassium to Ratio Measurement
C11929 PP Arterial O2/Fraction PAO2/FIO2;PP Arterial O2/Fraction Inspired O2 A relative measurement (ratio or Partial Pressure Arterial
3 Inspired O2 percentage) of the force per unit Oxygen to Fraction
area (pressure) of oxygen Inspired Oxygen Ratio
dissolved in arterial blood to the Measurement
percentage oxygen of an inhaled
mixture of gasses.
C13908 Prazepam Prazepam A measurement of the prazepam Prazepam Measurement

C10043 Prealbumin Prealbumin;Thyroxine-binding A measurement of the prealbumin Prealbumin Measurement

5 Prealbumin;Transthyretin in a biological specimen.
C74619 Precursor Plasma Cells Plasmablast;Precursor Plasma Cells A measurement of the precursor Precursor Plasma Cell
(blast stage) plasma cells Count
(antibody secreting cells derived
from B cells via antigen
stimulation) in a biological
specimen.
C74650 Precursor Plasma Precursor Plasma Cells/Lymphocytes A relative measurement (ratio or Precursor Plasma Cell to
Cells/Lymphocytes percentage) of the precursor (blast Lymphocyte Ratio
stage) plasma cells (antibody Measurement
secreting cells derived from B cells
via antigen stimulation) to all
specimen.
C82031 Pregnancy-Associated Pregnancy-Associated Plasma Protein-A A measurement of the pregnancy- Pregnancy-Associated

Plasma Protein-A associated plasma protein-A in a Plasma Protein-A
C14742 Pregnenolone Pregnenolone A measurement of the Pregnenolone

1 pregnenolone in a biological Measurement
specimen.
C82032 ProB-type Natriuretic Pro-Brain Natriuretic Peptide;ProB-type A measurement of the proB-type ProB-Type Natriuretic
Peptide Natriuretic Peptide;proBNP natriuretic peptide in a biological Peptide Measurement
specimen.
C10343 Procalcitonin Procalcitonin A measurement of the Procalcitonin Measurement

0 procalcitonin in a biological
specimen.
C96625 Procollagen 1 N-Terminal Amino-terminal propeptide of type 1 A measurement of the procollagen Procollagen 1 N-Terminal
Propeptide procollagen;P1NP Aminoterm Type 1;Procollagen 1 N-terminal propeptide in a Propeptide Measurement
1 N-Terminal Propeptide biological specimen.
C12897 Procollagen 3 N-Terminal Procollagen 3 N-Terminal Propeptide A measurement of the procollagen Procollagen 3 N-Terminal
3 Propeptide 3 N-terminal propeptide in a Propeptide Measurement
C82033 Procollagen Type I Procollagen Type I Carboxy Term Peptide A measurement of the Procollagen Type I
Carboxy Term Peptide procollagen-1 carboxy-terminal Carboxy Terminal Peptide
peptide in a biological specimen. Measurement
C74791 Progesterone Progesterone A measurement of the Progesterone

progesterone hormone in a Measurement
C11784 Progesterone Receptor NR3C3;PR;Progesterone Receptor A measurement of the Progesterone Receptor

6 progesterone receptor protein in a Measurement
C81967 Proinsulin Proinsulin A measurement of the proinsulin Proinsulin Measurement

page 846 of 1925

C6715 LBTEST
4
Code Value
C11129 Proinsulin/Insulin Ratio Proinsulin/Insulin Ratio A relative measurement (ratio or Proinsulin to Insulin Ratio
9 percentage) of the proinsulin to Measurement
insulin in a biological specimen.
C74870 Prolactin Prolactin A measurement of the prolactin Prolactin Measurement

C12064 Proliferating Cell Nuclear Cyclin;Proliferating Cell Nuclear Antigen A measurement of the Proliferating Cell Nuclear
6 Antigen proliferating cell nuclear antigen in Antigen Measurement
C12763 Proliferating Proliferating Erythroid/Total Cells A relative measurement (ratio or Proliferating Erythroid Cell
2 Erythroid/Total Cells percentage) of the proliferating to Total Cell Ratio
erythroid cells to total cells in a Measurement
C12763 Proliferating Myeloid Proliferating Myeloid Cells/Total Cells A relative measurement (ratio or Proliferating Myeloid Cell
4 Cells/Total Cells percentage) of the proliferating to Total Cell Ratio
myeloid cells to total cells in a Measurement
C12214 Proline Proline A measurement of the proline in a Proline Measurement

C74620 Prolymphocytes Prolymphocytes A measurement of the Prolymphocyte Count

prolymphocytes in a biological
specimen.
C64829 Prolymphocytes/Leukocyte Prolymphocytes/Leukocytes A relative measurement (ratio or Prolymphocyte to

s percentage) of prolymphocytes to Leukocyte Ratio
specimen.
C74651 Prolymphocytes/Lymphocy Prolymphocytes/Lymphocytes A relative measurement (ratio or Prolymphocyte to

tes percentage) of the prolymphocytes Lymphocyte Ratio
to all lymphocytes in a biological Measurement
specimen.
C74621 Promonocytes Promonocytes A measurement of the Promonocyte Count

promonocytes in a biological
specimen.
C74652 Promonocytes/Leukocytes Promonocytes/Leukocytes A relative measurement (ratio or Promonocyte to

percentage) of the promonocytes Lymphocyte Ratio
to all leukocytes in a biological Measurement
specimen.
C11784 Promyeloblasts Promyeloblasts A measurement of the Promyeloblasts

7 promyeloblasts in a biological Measurement
specimen.
C74622 Promyelocytes Promyelocytes A measurement of the Promyelocyte Count

promyelocytes (immature
myelocytes) in a biological
specimen.
C74653 Promyelocytes/Leukocytes Promyelocytes/Leukocytes A relative measurement (ratio or Promyelocyte to

percentage) of the promyelocytes Lymphocyte Ratio
(immature myelocytes) to all Measurement
specimen.
C98773 Promyelocytes/Total Cells Promyelocytes/Total Cells A relative measurement (ratio or Promyelocyte to Total Cell
percentage) of the promyelocytes Ratio Measurement
(immature myelocytes) to total
cells in a biological specimen (for
example a bone marrow
specimen).
C74885 Propoxyphene Propoxyphene A measurement of the Propoxyphene

propoxyphene present in a Measurement
C12064 Proprotein Convertase Proprotein Convertase Subtilisin/Kexin 9 A measurement of the proprotein Proprotein Convertase
7 Subtilisin/Kexin 9 convertase subtilisin/kexin type 9 Subtilisin/Kexin Type 9
C12897 Prorubricyte Basophilic Erythroblast;Basophilic A measurement of the Prorubricyte Count

6 Normoblast;Prorubricyte prorubricytes in a biological
specimen.
page 847 of 1925

C6715 LBTEST
4
Code Value
C12897 Prorubricyte/Total Cells Prorubricyte/Total Cells A relative measurement (ratio or Prorubricyte to Total Cell
7 percentage) of the prorubricytes Ratio Measurement
specimen.
C10334 Prostaglandin Prostaglandin A measurement of the total Prostaglandin

3 prostaglandin in a biological Measurement
specimen.
C10343 Prostaglandin D2 Prostaglandin D2 A measurement of the Prostaglandin D2

1 prostaglandin D2 in a biological Measurement
specimen.
C10343 Prostaglandin D2 Synthase Prostaglandin D2 Synthase A measurement of the Prostaglandin D2 Synthase

2 prostaglandin D2 synthase in a Measurement
C10343 Prostaglandin E Synthase Prostaglandin E Synthase A measurement of the Prostaglandin E Synthase

3 prostaglandin E synthase in a Measurement
C10343 Prostaglandin E1 Prostaglandin E1 A measurement of the Prostaglandin E1

4 prostaglandin E1 in a biological Measurement
specimen.
C10343 Prostaglandin E2 Prostaglandin E2 A measurement of the Prostaglandin E2

5 prostaglandin E2 in a biological Measurement
specimen.
C10343 Prostaglandin F1 Alpha Prostaglandin F1 Alpha A measurement of the Prostaglandin F1 Alpha

6 prostaglandin F1 alpha in a Measurement
C10343 Prostaglandin F2 Alpha Prostaglandin F2 Alpha A measurement of the Prostaglandin F2 Alpha

7 prostaglandin F2 alpha in a Measurement
C13237 Prostate Cancer Antigen 3 Prostate Cancer Antigen 3 mRNA A measurement of the prostate Prostate Cancer Antigen 3
9 mRNA cancer antigen 3 mRNA in a mRNA Measurement
C13238 Prostate Circulating Tumor Prostate Circulating Tumor Cells A measurement of the prostate Circulating Prostate Tumor
2 Cells circulating tumor cells in a Cell Count
C17634 Prostate Specific Antigen Prostate Specific Antigen A measurement of the total Prostate Specific Antigen
prostate specific antigen in a Measurement
C13238 Prostate Specific Antigen Prostate Specific Antigen mRNA A measurement of the prostate- Prostate Specific Antigen
5 mRNA specific antigen mRNA in a mRNA Measurement
C13238 Prostate Specific Antigen, Prostate Specific Antigen, Free A measurement of the unbound Free Prostate Specific
3 Free prostate-specific antigen in a Antigen Measurement
C80204 Prostatic Acid Phosphatase Prostatic Acid Phosphatase A measurement of the prostatic Prostatic Acid Phosphatase
acid phosphatase in a biological Measurement
specimen.
C64858 Protein Protein A measurement of the total Total Protein Measurement

C15082 Protein Excretion Rate Protein Excretion Rate A measurement of the amount of Protein Excretion Rate
2 total protein being excreted in a
C15084 Protein Induced by Vitamin DCP;Des-Gammacarboxyprothrombin;PIVKA- A measurement of the protein Protein Induced by
6 K Absence-II II;Protein Induced by Vitamin K Absence- induced by vitamin K absence-II in Vitamin K Absence-II
II;Protein Induced by Vitamin K a biological specimen. Measurement
Absence/Antagonist-II
C14742 Protein Pattern Protein Pattern A measurement of the protein Protein Pattern
2 band pattern in a biological Measurement
specimen.
C10043 Protein S Protein S A measurement of the total Protein S Measurement

6 protein S in a biological specimen.
page 848 of 1925

C6715 LBTEST
4
Code Value
C14742 Protein S Activity Protein S Activity Actual/Control;Protein S A relative measurement (ratio or Protein S Activity Actual to
4 Actual/Control Activity Actual/Normal;Protein S Activity percentage) of the biological Control Ratio
Actual/Protein S Activity Control activity of protein S in a subject's Measurement
specimen.
C14742 Protein S Free Activity Protein S Free Activity Actual/Control;Protein S A relative measurement (ratio or Free Protein S Activity
5 Actual/Control Free Activity Actual/Normal;Protein S Free percentage) of the biological Actual to Control Ratio
Activity Actual/Protein S Free Activity Control activity of free protein S in a Measurement
subject's specimen when
compared to the same activity in a
control specimen.
C12214 Protein S, Free Protein S, Free A measurement of the unbound Free Protein S
2 protein S in a biological specimen. Measurement
C79463 Protein/Creatinine Protein/Creatinine A relative measurement (ratio or Protein to Creatinine Ratio

percentage) of the total protein to Measurement
C92240 Protein/Osmolality Protein/Osmolality;Protein/Osmolality Ratio A relative measurement (ratio or Protein to Osmolality Ratio
percentage) of total proteins to Measurement
the osmolality of a biological
specimen.
C12064 Proteinase 3 Antibody Proteinase 3 Antibody A measurement of the proteinase Proteinase 3 Antibody
specimen.
C98774 Prothrombin Activity Factor II Activity;Prothrombin Activity A measurement of the biological Prothrombin Activity
activity of prothrombin in a Measurement
C82034 Prothrombin Fragments 1 Prothrombin Fragments 1 + 2 A measurement of the Prothrombin Fragments 1

+2 prothrombin fragments 1 and 2 in and 2 Measurement
C64805 Prothrombin Intl. Prothrombin Intl. Normalized Ratio A ratio that represents the International Normalized
Normalized Ratio prothrombin time for a plasma Ratio of Prothrombin Time
specimen, divided by the result for
a control plasma specimen, further
standardized for the International
Sensitivity Index of the tissue
factor (thromboplastin) used in the
test.
C62656 Prothrombin Time Prothrombin Time A blood clotting measurement that Prothrombin Time
evaluates the extrinsic pathway of
coagulation.
C14734 Protoporphyrin, Free Protoporphyrin, Free A measurement of the free Free Protoporphyrin
1 protoporphyrin (unbound to iron in Measurement
hemoglobin) in a biological
specimen.
C11784 Protozoa Protozoa Examination of a biological Protozoa Measurement

9 specimen to detect the presence
of protozoa in a biological
specimen.
C13238 PSA, Free/PSA PSA, Free/PSA A relative measurement Free PSA to Total PSA
4 (percentage) of the free prostate Ratio Measurement
specific antigen to total prostate
specific antigen in a biological
specimen.
C74696 Pseudoephedrine Pseudoephedrine A measurement of the Pseudoephedrine

pseudoephedrine present in a Measurement
C80211 Pyridinoline Pyridinoline A measurement of the pyridinoline Pyridinoline Measurement

C14742 Pyridinoline/Creatinine Pyridinoline/Creatinine A relative measurement (ratio or Pyridinoline to Creatinine

6 percentage) of the pyridinoline to Ratio Measurement
C14742 Pyruvate Pyruvate;Pyruvic Acid A measurement of the pyruvate in Pyruvate Measurement

page 849 of 1925

C6715 LBTEST
4
Code Value
C74716 Rapid Plasma Reagin Rapid Plasma Reagin A measurement of the antibodies Rapid Plasma Reagin
produced by cellular damage Measurement
caused by Treponema pallidum
(syphilis) in a biological specimen.
C74772 RBC Casts Erythrocyte Casts;RBC Casts A measurement of the red blood Red Blood Cell Cast
cell casts present in a biological Measurement
specimen.
C13907 RDW Standard Deviation RDW Standard Deviation;RDW-SD;Red Cell A measurement of the volume Red Cell Volume
1 Volume Distribution Width Standard Deviation dispersion within an erythrocyte Distribution Width
population, calculated as the width Standard Deviation
of the distribution curve at the 20
percent frequency level.
C74629 Reactive Lymphocytes Reactive Lymphocytes A measurement of the reactive Reactive Lymphocyte
lymphocytes (lymphocytes which Count Measurement
have become large due to an
antigen reaction) in a biological
specimen.
C74654 Reactive Reactive Lymphocytes/Lymphocytes A relative measurement (ratio or Reactive Lymphocyte to

Lymphocytes/Lymphocytes percentage) of the reactive Lymphocyte Ratio
lymphocytes (lymphocytes which Measurement
have become large due to an
antigen reaction) to all
specimen.
C12214 Reactive Oxygen Reactive Oxygen Metabolite A measurement of the reactive Reactive Oxygen
6 Metabolite oxygen metabolite in a biological Metabolite Measurement
specimen.
C11785 Receptor Activator Nuclear Receptor Activator Nuclear KappaB A measurement of the receptor Receptor Activator Nuclear
2 KappaB Ligand Ligand;Receptor Activator of Nuclear Kappa-B activator of nuclear kappa-B ligand KappaB Ligand
Ligand in a biological specimen. Measurement
C14742 Reducing Substances Reducing Substances A measurement of the reducing Reducing Substance
8 substances (e.g., sugars, Measurement
glutathione, creatinine, uric acid,
and ascorbic acid) in a biological
specimen.
C14742 Reducing Sugars Reducing Sugars A measurement of the reducing Reducing Sugar
9 sugars in a biological specimen. Measurement
C81957 Reg upon Act Normal T- Chemokine Ligand 5;Reg upon Act Normal T-cell A measurement of the RANTES Reg upon Act Normal T-
cell Exprd Secrtd Exprd Secrtd (regulated on activation, normally, cell Exprd Secrtd
T-cell expressed, and secreted) Measurement
chemokine in a biological
specimen.
C12065 Remnant Lipoprotein Remnant Lipoprotein A measurement of the remnant Remnant Lipoprotein
6 lipoproteins in a biological Measurement
specimen.
C14228 Renal Papillary Antigen 1 Renal Papillary Antigen 1 A measurement of the renal Renal Papillary Antigen 1
9 papillary antigen 1 in a biological Measurement
specimen.
C74893 Renin Active Renin;Angiotensinogenase;Direct A measurement of the renin in a Renin Measurement

Renin;Renin biological specimen.
C11130 Renin Activity Renin Activity A measurement of the renin Renin Activity
5 activity in a biological specimen. Measurement
C14743 Reptilase Activity Reptilase Activity Actual/Control;Reptilase A relative measurement (ratio or Reptilase Activity Actual to
0 Actual/Control Activity Actual/Normal;Reptilase Activity percentage) of the biological Control Ratio
Actual/Reptilase Activity Control activity of reptilase dependent Measurement
specimen.
C96628 Reptilase Time Reptilase Time A measurement of the time it Reptilase Time
takes a plasma sample to clot Measurement
after adding the active enzyme
reptilase.
C80205 Resistin Resistin A measurement of the resistin in a Resistin Measurement

page 850 of 1925

C6715 LBTEST
4
Code Value
C13906 Ret Corpuscular HGB Conc Ret Corpuscular HGB Conc Distr A measurement of the standard Reticulocyte Corpuscular
9 Distr Width Width;Reticulocyte Corpuscular Hemoglobin deviation of hemoglobin Hemoglobin Distribution
Distribution Width concentrations in reticulocytes in a Width
the standard deviation of
hemoglobin content divided by the
mean hemoglobin content.
C13907 Ret Hemoglobin Ret Hemoglobin Distribution Width;Reticulocyte A measurement of the distribution Reticulocyte Hemoglobin
0 Distribution Width Hemoglobin Concentration Distribution Width of the hemoglobin concentration in Distribution Width
reticulocytes.
C13907 Ret RDW Coefficient of RDWr-CV;Red Cell Volume Distribution Width A measurement of the volume Reticulocyte Volume
2 Variation Coefficient of Variation in Reticulocytes;Ret RDW dispersion within a reticulocyte Distribution Width
Coefficient of Variation;Reticulocyte Volume population, calculated as the Coefficient of Variation
Distribution Width Coefficient of Variation standard deviation of the mean
reticulocyte volume divided by the
mean reticulocyte volume,
multiplied by 100 to convert to a
percentage.
C13907 Ret RDW Standard RDWr-SD;Red Cell Volume Distribution Width A measurement of the volume Reticulocyte Volume
3 Deviation Standard Deviation in Reticulocytes;Ret RDW dispersion within a reticulocyte Distribution Width
Standard Deviation;Reticulocyte Volume population, calculated as the width Standard Deviation
Distribution Width Standard Deviation of the distribution curve at the 20
percent frequency level.
C13907 Ret Volume Distribution RDWr;Ret Volume Distribution A relative measurement (ratio or Reticulocyte Volume
4 Width Width;Reticulocyte Volume Distribution Width percentage) of the standard Distribution Width
deviation of the reticulocyte
volume to the mean distribution of
the reticulocyte volume in a
C98776 Ret. Corpuscular CHr;Ret. Corpuscular Hemoglobin A measurement of the total Reticulocyte Corpuscular
Hemoglobin Content Content;Reticulocyte Cellular Hemoglobin amount of hemoglobin in the Hemoglobin Content
Content reticulocyte population.
C13897 Ret. Corpuscular HGB Ret. Corpuscular HGB Concentration An indirect measurement of the Reticulocyte Corpuscular
0 Concentration Mean Mean;Reticulocyte Corpuscular Hemoglobin average concentration of Hemoglobin Concentration
Concentration Mean hemoglobin per reticulocyte in a Mean
the ratio of hemoglobin to
hematocrit.
C51947 Reticulocytes Reticulocytes A measurement of the Reticulocyte Count

reticulocytes in a biological
specimen.
C64828 Reticulocytes/Erythrocytes Reticulocytes/Erythrocytes A relative measurement (ratio or Reticulocyte to Erythrocyte

percentage) of reticulocytes to Ratio
specimen.
C10043 Retinol Binding Protein Retinol Binding Protein A measurement of the total retinol Retinol Binding Protein
7 binding protein in a biological Measurement
specimen.
C15472 Retinol Binding Retinol Binding Protein/Creatinine A relative measurement (ratio or Retinol Binding Protein to
9 Protein/Creatinine percentage) of the retinol binding Creatinine Ratio
protein to creatinine in a biological Measurement
specimen.
C13544 Retinyl Palmitate Retinol Palmitate;Retinyl Palmitate;Vitamin A A measurement of the endogenous Retinyl Palmitate
2 Palmitate retinyl palmitate vitamin A in a Measurement
C92948 Rh Factor Rh Factor A measurement of non-specified Rh Factor Measurement

Rhesus factor antigen(s) in a
C12594 RhD Factor RhD Factor A measurement of the Rhesus RhD Factor Measurement
8 factor D antigen in a biological
specimen.
C74717 Rheumatoid Factor Rheumatoid Factor A measurement of the rheumatoid Rheumatoid Factor
factor antibody in a biological Measurement
specimen.
C12065 Rheumatoid Factor IgA Rheumatoid Factor IgA Antibody A measurement of the rheumatoid Rheumatoid Factor
2 Antibody factor IgA antibody in a biological Antibody IgA
page 851 of 1925

C6715 LBTEST
4
Code Value
C12065 Rheumatoid Factor IgG Rheumatoid Factor IgG Antibody A measurement of the rheumatoid Rheumatoid Factor
3 Antibody factor IgG antibody in a biological Antibody IgG
C12065 Rheumatoid Factor IgM Rheumatoid Factor IgM Antibody A measurement of the rheumatoid Rheumatoid Factor
4 Antibody factor IgM antibody in a biological Antibody IgM
C74898 Riboflavin Riboflavin;Vitamin B2 A measurement of the riboflavin in Vitamin B2 Measurement

C13230 Ribonucleic Acid Ribonucleic Acid A measurement of a targeted Ribonucleic Acid

1 ribonucleic acid (RNA) in a Measurement
C10045 Ribonucleoprotein RNP Antibody;Ribonucleoprotein A measurement of the total Ribonucleoprotein

7 Antibody Antibody;Ribonucleoprotein Extractable Nuclear ribonucleoprotein antibodies in a Antibody Measurement
Antibody biological specimen.
C12065 Ribonucleoprotein Smith Ribonucleoprotein Smith Complex Antibody A measurement of the Ribonucleoprotein Smith
8 Complex Antibody ribonucleoprotein Smith complex Complex Antibody
C12065 Ribonucleoprotein-70 Ribonucleoprotein-70 Antibody;snRNP70 A measurement of the small Ribonucleoprotein-70

7 Antibody Antibody nuclear ribonucleoprotein 70 Antibody Measurement
C12065 Ribosomal P Protein Ribosomal P Protein Antibody A measurement of the total Ribosomal P Protein
9 Antibody ribosomal P protein antibody in a Antibody Measurement
C10041 Ringed Sideroblasts Ringed Sideroblasts A measurement of the ringed Ring Sideroblast
9 sideroblasts (abnormal nucleated Measurement
erythroblasts with a large number
of iron deposits in the perinuclear
mitochondria, forming a ring
around the nucleus) in a biological
specimen.
C12065 RLP Cholesterol RLP Cholesterol A measurement of the cholesterol Remnant-like Particle
5 remnant-like particles in a Cholesterol Measurement
C12214 RNA Polymerase III IgG RNA Polymerase III IgG Antibody A measurement of the RNA RNA Polymerase III IgG
7 Antibody polymerase III IgG antibody in a Antibody Measurement
C74624 Rouleaux Formation Rouleaux Formation A measurement of the stacking Rouleaux Formation Count
red blood cells in a biological
specimen.
C14228 Round Cells Round Cells A measurement of the round cells Round Cell Count
8 (round shaped cells mainly
comprised of white blood cells and
immature spermatogenic cells) in
C74698 Round Epithelial Cells Round Epithelial Cells A measurement of the round Round Epithelial Cell Count
epithelial cells present in a
C10344 Rubella IgG Antibody Rubella IgG Antibody A measurement of the Rubella IgG Rubella IgG Antibody
C11241 Rubeola IgG Antibody Measles IgG Antibody;Rubeola IgG Antibody A measurement of the Measles Rubeola IgG Antibody
2 (Rubeola) virus IgG antibody in a Measurement
C11241 Rubeola IgM Antibody Measles IgM Antibody;Rubeola IgM Antibody A measurement of the Measles Rubeola IgM Antibody
3 (Rubeola) virus IgM antibody in a Measurement
C10044 Rubriblast Proerythroblast;Pronormoblast;Rubriblast A measurement of the rubriblasts Proerythroblast

C98870 Rubriblast/Total Cells Proerythroblast/Total Cells;Pronormoblasts/Total A relative measurement (ratio or Pronormoblast to Total
Cells;Rubriblast/Total Cells percentage) of the rubriblasts to Cell Ratio Measurement
specimen).
page 852 of 1925

C6715 LBTEST
4
Code Value
C12897 Rubricyte Polychromatophilic A measurement of the rubricytes Rubricyte Count

8 Erythroblast;Polychromatophilic in a biological specimen.
Normoblast;Rubricyte
C12900 Rubricyte/Total Cells Rubricyte/Total Cells A relative measurement (ratio or Rubricyte to Total Cell
6 percentage) of the rubricytes to Ratio Measurement
C14224 S. pneumoniae Sero 1 IgG S. pneumonia Sero 1 IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
9 AB pneumoniae Serotype 1 IgG Antibody Streptococcus pneumoniae Serotype 1 IgG Antibody
serotype 1 IgG antibody in a Measurement
C14225 S. pneumoniae Sero 10A S. pneumonia Sero 10A IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
9 IgG AB pneumoniae Serotype 10A IgG Antibody Streptococcus pneumoniae Serotype 10A IgG
serotype 10A IgG antibody in a Antibody Measurement
C14226 S. pneumoniae Sero 12F S. pneumonia Sero 12F IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
1 IgG AB pneumoniae Serotype 12F IgG Antibody Streptococcus pneumoniae Serotype 12F IgG
serotype 12F IgG antibody in a Antibody Measurement
C14226 S. pneumoniae Sero 14 S. pneumonia Sero 14 IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
2 IgG AB pneumoniae Serotype 14 IgG Antibody Streptococcus pneumoniae Serotype 14 IgG Antibody
C14226 S. pneumoniae Sero 15B S. pneumonia Sero 15B IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
3 IgG AB pneumoniae Serotype 15B IgG Antibody Streptococcus pneumoniae Serotype 15B IgG
serotype 15B IgG antibody in a Antibody Measurement
C14226 S. pneumoniae Sero 18C S. pneumonia Sero 18C IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
5 IgG AB pneumoniae Serotype 18C IgG Antibody Streptococcus pneumoniae Serotype 18C IgG
serotype 18C IgG antibody in a Antibody Measurement
C14226 S. pneumoniae Sero 20 S. pneumonia Sero 20 IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
8 IgG AB pneumoniae Serotype 20 IgG Antibody Streptococcus pneumoniae Serotype 20 IgG Antibody
page 853 of 1925

C6715 LBTEST
4
Code Value
C14225 S. pneumoniae Sero 6B S. pneumonia Sero 6B IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
4 IgG AB pneumoniae Serotype 6B IgG Antibody Streptococcus pneumoniae Serotype 6B IgG Antibody
serotype 6B IgG antibody in a Measurement
5 IgG AB pneumoniae Serotype 7F IgG Antibody Streptococcus pneumoniae Serotype 7F IgG Antibody
serotype 7F IgG antibody in a Measurement
C14225 S. pneumoniae Sero 9N S. pneumonia Sero 9N IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
7 IgG AB pneumoniae Serotype 9N IgG Antibody Streptococcus pneumoniae Serotype 9N IgG Antibody
serotype 9N IgG antibody in a Measurement
C14225 S. pneumoniae Sero 9V S. pneumonia Sero 9V IgG AB;Streptococcus A measurement of the Streptococcus pneumoniae
8 IgG AB pneumoniae Serotype 9V IgG Antibody Streptococcus pneumoniae Serotype 9V IgG Antibody
serotype 9V IgG antibody in a Measurement
C15473 S100 Calcium Binding S100 Calcium Binding Protein A8 A measurement of the S100 S100 Calcium Binding
0 Protein A8 calcium binding protein A8 in a Protein A8 Measurement
C12763 S100 Calcium-Binding S100 Calcium-Binding Protein B A measure of the S100 calcium- S100 Calcium-Binding
5 Protein B binding protein B in a biological Protein B Measurement
specimen.
C14743 Salicylates Salicylates A measurement of the salicylates Salicylates Measurement

C15476 Sarcosine N-Methylglycine;Sarcosine A measurement of the sarcosine in Sarcosine Measurement

C74706 Schistocytes Schistocytes A measurement of the schistocytes Schistocyte Count

(fragmented red blood cells) in a
C10045 Scl-70 Antibody Scl-70 Antibody;Scleroderma-70 Antibody A measurement of the total Scl-70 Scl-70 Antibody
C12214 Scl-70 IgG Antibody Scl-70 IgG Antibody;Scleroderma-70 IgG A measurement of the Scl-70 IgG Scl-70 IgG Antibody
8 Antibody antibody in a biological specimen. Measurement
C11785 Sclerostin Sclerostin A measurement of the sclerostin in Sclerostin Measurement

C75369 Secobarbital Secobarbital A measurement of the secobarbital Secobarbital Measurement

C74871 Secretin Secretin A measurement of the secretin Secretin Measurement

C10574 Sediment Examination Microscopic Sediment Analysis;Sediment An observation, assessment or Sediment Analysis
4 Analysis;Sediment Examination examination of the sediment in a
C12214 Serine Serine A measurement of the serine in a Serine Measurement

C74872 Serotonin Serotonin A measurement of the serotonin Serotonin Measurement

page 854 of 1925

C6715 LBTEST
4
Code Value
C14743 Sertraline Sertraline A measurement of the sertraline Sertraline Measurement

C74745 Sex Hormone Binding Sex Hormone Binding Globulin;Sex Hormone A measurement of the sex Sex Hormone Binding
Globulin Binding Protein hormone binding (globulin) protein Protein Measurement
C74625 Sezary Cells Sezary Cells A measurement of the Sezary cells Sezary Cell Count
(atypical lymphocytes with
cerebriform nuclei) in a biological
specimen.
C74655 Sezary Cells/Lymphocytes Sezary Cells/Lymphocytes A relative measurement (ratio or Sezary Cell to Lymphocyte
percentage of the Sezary cells Ratio Measurement
(atypical lymphocytes with
cerebriform nuclei) to all
specimen.
C13012 Shellfish Mix Antigen IgE Shellfish Mix Antigen IgE Antibody A measurement of the shellfish Shellfish Mix Antigen IgE
0 Antibody mix antigen IgE antibody in a Antibody Measurement
C13012 Shellfish Mix Antigen IgG Shellfish Mix Antigen IgG Antibody A measurement of the shellfish Shellfish Mix Antigen IgG
1 Antibody mix antigen IgG antibody in a Antibody Measurement
C11422 Sialyl SSEA-1 Antigen SLeX;Sialyl Lewis X Antigen;Sialyl Lex;Sialyl A measurement of the sialyl stage- Sialyl SSEA-1 Antigen
3 SSEA-1 Antigen;Sialyl-CD15 specific embryonic antigen-1 in a Measurement
C74626 Sickle Cells Sickle Cells A measurement of the sickle cells Sickle Cell Count
(sickle shaped red blood cells) in a
C74656 Sickle Cells/Erythrocytes Sickle Cells/Erythrocytes A relative measurement (ratio or Sickle Cell to Erythrocyte
percentage) of the sickle cells Ratio Measurement
(sickle shaped red blood cells) to
all erythrocytes in a biological
specimen.
C10041 Sideroblast Sideroblast A measurement of the sideroblasts Sideroblast Measurement

8 (nucleated erythroblasts with iron
granules in the cytoplasm) in a
C13007 Silver Birch Pollen IgA Silver Birch Pollen IgA A measurement of the Betula Silver Birch Pollen IgA
7 verrucosa pollen antigen IgA Measurement
C13007 Silver Birch Pollen IgE Silver Birch Pollen IgE A measurement of the Betula Silver Birch Pollen IgE
6 verrucosa pollen antigen IgE Measurement
C13007 Silver Birch Pollen IgG Silver Birch Pollen IgG A measurement of the Betula Silver Birch Pollen IgG
8 verrucosa pollen antigen IgG Measurement
C13007 Silver Birch Pollen IgG4 Silver Birch Pollen IgG4 A measurement of the Betula Silver Birch Pollen IgG4
9 verrucosa pollen antigen IgG4 Measurement
C92236 Sjogrens SS-A Antibody Ro Antibody;Sjogrens SS-A Antibody A measurement of the Sjogrens Sjogren's SS-A Antibody
SS-A antibody in a biological Measurement
specimen.
C12066 Sjogrens SS-A52 Antibody Sjogrens SS-A52 Antibody A measurement of the Sjogrens Sjogrens SS-A52 Antibody
1 SS-A52 antibody in a biological Measurement
specimen.
C12066 Sjogrens SS-A60 Antibody Sjogrens SS-A60 Antibody A measurement of the Sjogrens Sjogrens SS-A60 Antibody
2 SS-A60 antibody in a biological Measurement
specimen.
C92237 Sjogrens SS-B Antibody La Antibody;Sjogrens SS-B Antibody A measurement of the Sjogrens Sjogren's SS-B Antibody
SS-B antibody in a biological Measurement
specimen.
C13544 Skeletal Troponin I Skeletal Troponin I;sTnl A measurement of the total Skeletal Troponin I
3 skeletal troponin I in a biological Measurement
specimen.
page 855 of 1925

C6715 LBTEST
4
Code Value
C92281 Smith Antibody Smith Antibody;Smith Extractable Nuclear A measurement of the total Smith Smith Antibody
Antibody antibodies in a biological Measurement
specimen.
C11131 Smooth Muscle Antibody Anti-Smooth Muscle Antibody;Smooth Muscle A measurement of the total Smooth Muscle Antibody
7 Antibody smooth muscle antibody in a Measurement
C12215 Smooth Muscle IgG Actin IgG Antibody;Smooth Muscle IgG Antibody A measurement of the smooth Smooth Muscle IgG
1 Antibody muscle IgG antibody in a biological Antibody Measurement
specimen.
C74627 Smudge Cells Basket Cells;Gumprecht Shadow Cells;Shadow A measurement of the smudge Smudge Cell Count
Cells;Smudge Cells cells (the nuclear remnant of a
ruptured white blood cell) in a
C11929 Smudge Cells/Leukocytes Basket Cells/Leukocytes;Gumprecht Shadow A relative measurement (ratio or Smudge Cells to
4 Cells/Leukocytes;Shadow percentage) of smudge cells to Leukocytes Ratio
Cells/Leukocytes;Smudge Cells/Leukocytes leukocytes in a biological Measurement
specimen.
C64809 Sodium Sodium A measurement of the sodium in a Sodium Measurement

C10656 Sodium Clearance Sodium Clearance A measurement of the volume of Sodium Clearance
cleared of sodium by excretion of
(e.g. one minute).
C15082 Sodium Excretion Rate Sodium Excretion Rate A measurement of the amount of Sodium Excretion Rate
3 sodium being excreted in a
C79464 Sodium/Creatinine Sodium/Creatinine A relative measurement (ratio or Sodium to Creatinine Ratio

percentage) of the sodium to Measurement
C12213 Sodium/Potassium Sodium/Potassium A relative measurement (ratio or Sodium to Potassium Ratio

7 percentage) of the sodium to Measurement
potassium in a biological
specimen.
C15472 Soluble CD163 Soluble CD163 A measurement of the soluble Soluble CD163
8 CD163 in a biological specimen. Measurement
C11927 Soluble E-Selectin Soluble E-Selectin;sE-selectin A measurement of the soluble E- Soluble E-Selectin
3 Selectin activity in a biological Measurement
specimen.
C11783 Soluble Immunoglobulin Soluble Immunoglobulin A measurement of the soluble Soluble Immunoglobulin
5 total immunoglobulin in a Measurement
C13238 Soluble Intercell Adhesion Soluble Intercell Adhesion Molecule 1 A measurement of the soluble Soluble Intercellular
6 Molecule 1 intercellular adhesion molecule 1 Adhesion Molecule 1
C10228 Soluble Interleukin 2 Soluble Interleukin 2 Receptor Activity A measurement of the soluble Soluble Interleukin 2
0 Receptor Activity interleukin 2 receptor activity in a Receptor Activity
C11783 Soluble Interleukin 6 Soluble Interleukin 6 Receptor A measurement of the soluble Soluble Interleukin 6
7 Receptor interleukin 6 receptor in a Receptor Measurement
C11783 Soluble Interleukin-1 Soluble Interleukin-1 Receptor Type I A measurement of the soluble Soluble Interleukin-1
6 Receptor Type I interleukin-1 receptor type I in a Receptor Type I
C12215 Soluble Liver Antigen IgG Soluble Liver Antigen IgG Antibody A measurement of the soluble liver Soluble Liver Antigen IgG
C12065 Soluble P-Selectin Soluble P-Selectin A measurement of the soluble P- Soluble P-Selectin
0 selectin in a biological specimen. Measurement
C11786 Soluble TNF Receptor Type Soluble TNF Receptor Type I A measurement of the soluble Soluble Tumor Necrosis
3 I tumor necrosis factor receptor Factor Receptor Type I
type I in a biological specimen. Measurement
page 856 of 1925

C6715 LBTEST
4
Code Value
C11786 Soluble TNF Receptor Type Soluble TNF Receptor Type II A measurement of the soluble Soluble Tumor Necrosis
4 II tumor necrosis factor receptor Factor Receptor Type II
type II in a biological specimen. Measurement
C10043 Soluble Transferrin Soluble Transferrin Receptor A measurement of the soluble Soluble Transferrin
8 Receptor transferrin receptor in a biological Receptor Measurement
specimen.
C11774 Soluble Tumor Necrosis Soluble Tumor Necrosis Factor Receptor A measurement of the total Soluble Tumor Necrosis
9 Factor Receptor soluble tumor necrosis factor Factor Receptor
receptor in a biological specimen. Measurement
C92533 Soluble Vasc Cell Adhesion Soluble Vasc Cell Adhesion Molecule 1 A measurement of the soluble Soluble Vascular Cell
Molecule 1 vascular cell adhesion molecule 1 Adhesion Molecule 1
C80360 Somatotrophin Growth Hormone;Somatotrophin;Somatotropin A measurement of the Somatotrophin

somatotrophin (growth) hormone Measurement
C79465 Sorbitol Dehydrogenase Sorbitol Dehydrogenase A measurement of the sorbitol Sorbitol Dehydrogenase
specimen.
C64832 Specific Gravity Specific Gravity A ratio of the density of a fluid to Specific Gravity
the density of water.
C25377 Specimen Appearance Specimen Appearance The outward or visible aspect of a Appearance
specimen.
C10656 Specimen Weight Specimen Weight A measurement of the weight of a Specimen Weight
9 biological specimen. Measurement
C14229 Sperm Agglutination Sperm Agglutination A measurement of the motile Sperm Agglutination
0 spermatozoa agglutination in a Measurement
C14229 Sperm Aggregation Sperm Aggregation A measurement of the immotile Sperm Aggregation
1 spermatozoa aggregation in a Measurement
C10228 Sperm Motility Sperm Motility A measurement of the sperm Sperm Motility
1 capable of forward, progressive Measurement
movement in a semen specimen.
C74663 Spermatozoa Spermatozoa A measurement of the Spermatozoa Cell Count

spermatozoa cells present in a
C74707 Spherocytes Spherocytes A measurement of the spherocytes Spherocyte Count

(small, sphere-shaped red blood
cells) in a biological specimen.
C12066 Squamous Cell Carcinoma Squamous Cell Carcinoma Antigen A measurement of the squamous Squamous Cell Carcinoma
0 Antigen cell carcinoma antigen in a Antigen Measurement
C74773 Squamous Epithelial Cells Squamous Epithelial Cells A measurement of the squamous Squamous Epithelial Cell
epithelial cells present in a Count
C13236 Squamous Epithelial Squamous Epithelial Cells/Total Cells A relative measurement (ratio or Squamous Epithelial Cells
6 Cells/Total Cells percentage) of the squamous to Total Cells Ratio
epithelial cells to total cells in a Measurement
C74774 Squamous Transitional Squamous Transitional Epithelial Cells A measurement of the squamous Squamous Transitional
Epithelial Cells transitional epithelial cells present Epithelial Cell Count
C15472 Standard Base Excess Standard Base Excess A calculated measurement of the Standard Base Excess
1 amount of acid required to return Measurement
blood with hemoglobin at 5g/dL,
which is used as a surrogate for
extracellular fluid, to a normal pH
under standard conditions.
C81951 Starch Crystals Starch Crystals A measurement of the starch Starch Crystal
crystals in a biological specimen. Measurement
C82035 Stem Cell Factor KIT Ligand;Stem Cell Factor A measurement of the stem cell Stem Cell Factor
page 857 of 1925

C6715 LBTEST
4
Code Value
C74708 Stomatocytes Stomatocytes A measurement of the Stomatocyte Count

stomatocytes (red blood cells with
an oval or rectangular area of
central pallor, producing the
appearance of a cell mouth) in a
C12215 Streptococcus pneumoniae Streptococcus pneumoniae Antigen A measurement of the Streptococcus pneumoniae
2 Antigen Streptococcus pneumoniae antigen Antigen Measurement
C14223 Streptococcus pneumoniae Streptococcus pneumoniae IgG Antibody A measurement of the Streptococcus pneumoniae
2 IgG Antibody Streptococcus pneumoniae IgG IgG Antibody
C92282 Streptolysin O Antibody Antistreptolysin O;Streptolysin O Antibody A measurement of Streptolysin O Streptolysin O Antibody
Antibody in a biological specimen. Measurement
C11785 Strongyloides IgG Strongyloides IgG Antibody A measurement of strongyloides Strongyloides IgG
8 Antibody IgG antibody in a biological Antibody Measurement
specimen.
C74755 Sulfa Crystals Sulfa Crystals;Sulfonamide Crystals A measurement of the sulfa Sulfa Crystal Measurement
crystals present in a biological
specimen.
C12215 Sulfate Sulfate;Sulphate A measurement of the sulfate in a Sulfate Measurement

C11422 Sulfur Dioxide Sulfur Dioxide A measurement of the sulfur Sulfur Dioxide
4 dioxide in a biological specimen. Measurement
C11132 Surfactant Protein D SP-D;Surfactant Protein D A measurement of the surfactant Surfactant Protein D
2 protein D in a biological specimen. Measurement
C13238 T-Kininogen T-Kininogen A measurement of the total T- T-Kininogen Measurement

7 kininogen in a biological specimen.
C12897 T-lymphocyte Crossmatch T-lymphocyte Crossmatch A measurement to determine T-lymphocyte Crossmatch

9 human leukocyte antigens (HLA) Measurement
histocompatibility between the
recipient and the donor by
examining the presence or
absence of the recipient's anti-HLA
antibody reactivity towards HLA
antigens expressed on the donor
T-lymphocytes.
C12215 T-Lymphocytes T-Lymphocytes A measurement of the total T-Lymphocyte Count

7 thymocyte-derived lymphocytes in
C14740 T1 Collagen X-link N- T1 Collagen X-link N-Telopeptides/Creat;Type I A relative measurement (ratio or Type 1 Collagen X-link N-
8 Telopeptides/Creat Collagen X-linked N-Telopeptides/Creatinine percentage) of the type 1 collagen Telopeptides to Creatinine
cross-linked N-telopeptides to Ratio Measurement
C96636 Target Cells Codocytes;Leptocytes;Mexican Hat Cells;Target A measurement of the target cells Target Cell Count
Cells in a biological specimen.
C11786 Tartrate-Resistant Acid TRAP5B;Tartrate-Resistant Acid Phosphatase 5b A measurement of tartrate- Tartrate-Resistant Acid
5 Phosphatase 5b resistant acid phosphatase 5b in a Phosphatase 5b
C84810 Tau Protein Tau Protein;Total Tau Protein A measurement of the total Tau Tau Protein Measurement
C12215 Taurine Tauric Acid;Taurine A measurement of the taurine in a Taurine Measurement

C75376 Temazepam Temazepam A measurement of the temazepam Temazepam Measurement

C11785 Terminal Deoxynucleotidyl Terminal Deoxynucleotidyl Transferase A measurement of the terminal Terminal Deoxynucleotidyl
9 Transferase Ag Ag;Terminal Deoxynucleotidyl Transferase deoxynucleotidyl transferase Transferase Antigen
Antigen antigen in a biological specimen. Measurement
C74793 Testosterone Testosterone;Total Testosterone A measurement of the total (free Total Testosterone
and bound) testosterone in a Measurement
page 858 of 1925

C6715 LBTEST
4
Code Value
C14744 Testosterone Free+Weakly Testosterone Free+Weakly A relative measurement (ratio or Free Testosterone and
0 Bound/Testost Bound/Testost;Testosterone, Free and Weakly percentage) of the free and weakly Weakly Bound to Total
Bound/Testosterone bound testosterone to total Testosterone Ratio
testosterone in a biological Measurement
specimen.
C74785 Testosterone, Free Testosterone, Free A measurement of the free Free Testosterone
testosterone in a biological Measurement
specimen.
C14743 Testosterone, Testosterone, Free/Testosterone A relative measurement (ratio or Free Testosterone to

9 Free/Testosterone percentage) of the amount of the Testosterone Ratio
bioavailable testosterone Measurement
compared to total testosterone in
C12898 Testosterone, Free/Total Testosterone, Free/Total Protein A relative measurement (ratio or Free Testosterone to Total
0 Protein percentage) of free testosterone to Protein Ratio Measurement
total proteins in a biological
specimen.
C14743 Testosterone, Weakly Testosterone, Weakly Bound A measurement of the weakly Weakly Bound
4 Bound bound testosterone (testosterone Testosterone
bound to albumin) in a biological Measurement
specimen.
C14743 Tetrahydrocannabinol Tetrahydrocannabinol A measurement of the Tetrahydrocannabinol

6 tetrahydrocannabinol in a Measurement
C10544 Theophylline Theophylline A measurement of the Theophylline Measurement

5 Theophylline present in a
C74896 Thiamine Thiamine;Vitamin B1 A measurement of the thiamine in Vitamin B1 Measurement

C15474 Thiocyanate Thiocyanate A measurement of the thiocyanate Thiocyanate Measurement

C12215 Threonine Threonine A measurement of the threonine in Threonine Measurement

C14743 Thrombin Activity Thrombin Activity Actual/Control;Thrombin A relative measurement (ratio or Thrombin Activity Actual
7 Actual/Control Activity Actual/Normal;Thrombin Activity percentage) of the biological to Control Ratio
Actual/Thrombin Activity Control activity of thrombin dependent Measurement
specimen.
C80365 Thrombin Time Thrombin Time A measurement of the time it Thrombin Time
takes a plasma sample to clot
after adding the active enzyme
thrombin. (NCI)
C10657 Thrombin/Antithrombin Thrombin/Antithrombin;Thrombin/Antithrombin A relative measurement (ratio or Thrombin to Antithrombin

4 III percentage) of the thrombin to Ratio Measurement
antithrombin present in a sample.
C11128 Thrombocytes Nucleated Thrombocytes;Thrombocytes A measurement of the nucleated Nucleated Thrombocyte

3 platelets, namely thrombocytes, in Count
a biological specimen. This is
typically measured in birds and
other non-mammalian
vertebrates.
C13544 Thrombomodulin BDCA3;Thrombomodulin A measurement of the Thrombomodulin

4 thrombomodulin in a biological Measurement
specimen.
C74873 Thrombopoietin Thrombopoietin A measurement of the Thrombopoietin

thrombopoietin hormone in a Measurement
C10344 Thromboxane B2 Thromboxane B2 A measurement of the Thromboxane B2

5 thromboxane B2 in a biological Measurement
specimen.
C12066 Thymidine Kinase Thymidine Kinase A measurement of the total Thymidine Kinase
5 thymidine kinase in a biological Measurement
specimen.
page 859 of 1925

C6715 LBTEST
4
Code Value
C13544 Thymidine Kinase 1 Thymidine Kinase 1;Thymidine Kinase, Cytosolic A measurement of the thymidine Thymidine Kinase 1
5 kinase 1 in a biological specimen. Measurement
C13544 Thymidine Kinase 2 Thymidine Kinase 2;Thymidine Kinase, A measurement of the thymidine Thymidine Kinase 2
6 Mitochondrial kinase 2 in a biological specimen. Measurement
C10344 Thyroglobulin TG;Thyroglobulin A measurement of the Thyroglobulin

6 thyroglobulin in a biological Measurement
specimen.
C14743 Thyroglobulin Recovery Thyroglobulin Recovery Rate A measurement of the Thyroglobulin Recovery
5 Rate thyroglobulin recovery rate in a Rate
biological specimen obtained by
measuring the thyroglobulin
concentration before and after a
known amount of thyroglobulin
has been added to the specimen.
C81990 Thyroid Antibodies Thyroid Antibodies A measurement of the thyroid Thyroid Antibody
specimen.
C81991 Thyroid Antimicrosomal Thyroid Antimicrosomal Antibodies A measurement of the thyroid Thyroid Antimicrosomal
Antibodies antimicrosomal antibodies in a Antibody Measurement
C81992 Thyroid Antithyroglobulin Thyroid Antithyroglobulin Antibodies A measurement of the thyroid Thyroid Antithyroglobulin
Antibodies antithyroglobulin antibodies in a Antibody Measurement
C14743 Thyroid Stimulating Thyroid Stimulating Immunoglobulin A measurement of the thyroid Thyroid Stimulating
8 Immunoglobulin stimulating immunoglobulin in a Immunoglobulin
C96639 Thyroperoxidase Thyroid Peroxidase;Thyroperoxidase A measurement of the Thyroperoxidase

thyroperoxidase in a biological Measurement
specimen.
C96638 Thyroperoxidase Antibody Thyroperoxidase Antibody A measurement of the Thyroperoxidase Antibody

thyroperoxidase antibody in a Measurement
C64813 Thyrotropin Thyroid Stimulating Hormone;Thyrotropin A measurement of the thyrotropin Thyrotropin Measurement
C12215 Thyrotropin Receptor Thyroid Stimulating Hormone Receptor A measurement of the thyrotropin Thyroid Stimulating
8 Antibody Antibody;Thyrotropin Receptor Antibody receptor antibody in a biological Hormone Receptor
specimen. Antibody Measurement
C74874 Thyrotropin Releasing Thyrotropin Releasing Factor;Thyrotropin A measurement of the thyrotropin Thyrotropin Releasing
Hormone Releasing Hormone releasing hormone in a biological Hormone Measurement
specimen.
C74794 Thyroxine Thyroxine;Total T4 A measurement of the total (free Total Thyroxine

and bound) thyroxine in a Measurement
C74746 Thyroxine Binding Globulin Thyroxine Binding Globulin A measurement of the thyroxine Thyroxine Binding Globulin
binding globulin protein in a Protein Measurement
C74786 Thyroxine, Free Free T4;Thyroxine, Free A measurement of the free Free Thyroxine
thyroxine in a biological specimen. Measurement
C12066 Thyroxine, Free, Indirect Thyroxine, Free, Indirect An indirect measurement of the Indirect Free Thyroxine
4 free thyroxine in a biological Measurement
specimen.
C13008 Timothy Grass Pollen IgA Timothy Grass Pollen IgA A measurement of the Phleum Timothy Grass Pollen IgA
9 pratense pollen antigen IgA Measurement
C13008 Timothy Grass Pollen IgE Timothy Grass Pollen IgE A measurement of the Phleum Timothy Grass Pollen IgE
8 pratense pollen antigen IgE Measurement
C13009 Timothy Grass Pollen IgG Timothy Grass Pollen IgG A measurement of the Phleum Timothy Grass Pollen IgG
0 pratense pollen antigen IgG Measurement
C13009 Timothy Grass Pollen IgG4 Timothy Grass Pollen IgG4 A measurement of the Phleum Timothy Grass Pollen IgG4
1 pratense pollen antigen IgG4 Measurement
page 860 of 1925

C6715 LBTEST
4
Code Value
C10657 TIMP1/Creatinine TIMP1/Creatinine;Tissue Inhibitor of A relative measurement (ratio or Tissue Inhibitor of

5 Metalloproteinase 1/Creatinine percentage) of the tissue inhibitor Metalloproteinase 1 to
of metalloproteinase 1 to Creatinine Ratio
creatinine present in a sample. Measurement
C82036 Tissue Inhibitor of Tissue Inhibitor of Metalloproteinase 1 A measurement of the tissue Tissue Inhibitor of
Metalloproteinase 1 inhibitor of metalloproteinase 1 in Metalloproteinase 1
C81993 Tissue Plasminogen Tissue Plasminogen Activator Antigen A measurement of the tissue Tissue Plasminogen
Activator Antigen plasminogen activator antigen in a Activator Antigen
C14744 Tissue Transglutaminase Tissue Transglutaminase IgA Antibody A measurement of the tissue Tissue Transglutaminase
1 IgA Antibody transglutaminase IgA antibody in a IgA Antibody
C14744 Tissue Transglutaminase Tissue Transglutaminase IgM Antibody A measurement of the tissue Tissue Transglutaminase
2 IgM Antibody transglutaminase IgM antibody in IgM Antibody
C11786 TNF-a Production TNF-a Production Inhibitory Activity A measurement of TNF-a TNF-a Production
2 Inhibitory Activity production inhibitory activity in a Inhibitory Activity
C11926 Total Amyloid Precursor Total Amyloid Precursor Protein A measurement of the total Total Amyloid Precursor
9 Protein amyloid precursor protein present Protein Measurement
C74718 Total Iron Binding Capacity Total Iron Binding Capacity A measurement of the amount of Total Iron Binding
iron needed to fully saturate the Capacity
specimen.
C12897 Total Plasma Cells Total Plasma Cells A measurement of the total Plasma Cell Count
4 plasma cells in a biological
specimen.
C12897 Total Plasma Total Plasma Cells/Leukocytes A relative measurement (ratio or Plasma Cells to Leukocytes
5 Cells/Leukocytes percentage) of the total plasma Ratio Measurement
cells to leukocytes in a biological
specimen.
C80208 Total Radical-Trap Total Radical-Trap Antioxidant Potential A measurement of the ability of Total Radical-Trap
Antioxidant Potential the antioxidants in a biological Antioxidant Potential
specimen to buffer free radicals in Measurement
a suspension.
C96641 Toxic Granulation Toxic Granulation A measurement of the toxic Toxic Granulation
granulation in granulocytic blood Measurement
cells.
C12781 Toxic Vacuolation Toxic Vacuolation A measurement of the toxic Toxic Vacuolation
3 vacuolation in any of the Assessment
granulocytic blood cells.
C13908 Toxoplasma gondii IgG Toxoplasma gondii IgG Antibody A measurement of the Toxoplasma Toxoplasma gondii IgG
9 Antibody gondii IgG antibody in a biological Antibody Measurement
specimen.
C13909 Toxoplasma gondii IgM Toxoplasma gondii IgM Antibody A measurement of the Toxoplasma Toxoplasma gondii IgM
0 Antibody gondii IgM antibody in a biological Antibody Measurement
specimen.
C82037 Transferrin Transferrin A measurement of the total Transferrin Measurement

specimen.
C98792 Transferrin Saturation Iron Binding Capacity Saturation;Iron A measurement of the iron bound Transferrin Saturation
Saturation;Iron to TIBC;Transferrin Saturation to transferrin in a biological Measurement
specimen.
C12215 Transforming Growth Transforming Growth Factor Beta A measurement of the total Transforming Growth
5 Factor Beta transforming growth factor beta in Factor Beta Measurement
C11786 Transforming Growth Transforming Growth Factor Beta 1 A measurement of the Transforming Growth
1 Factor Beta 1 transforming growth factor beta 1 Factor Beta 1
C92251 Transitional Epithelial Cells Transitional Epithelial Cells A measurement of the transitional Transitional Epithelial Cells
epithelial cells present in a Measurement
page 861 of 1925

C6715 LBTEST
4
Code Value
C13010 Tree Mix Pollen Antigen Tree Mix Pollen Antigen IgE Antibody A measurement of the tree mix Tree Mix Pollen Antigen
1 IgE Antibody pollen antigen IgE antibody in a IgE Antibody Measurement
C13010 Tree Mix Pollen Antigen Tree Mix Pollen Antigen IgG Antibody A measurement of the tree mix Tree Mix Pollen Antigen
2 IgG Antibody pollen antigen IgG antibody in a IgG Antibody
C13238 Treponema pallidum Treponema pallidum Antibody A measurement of the total Treponema pallidum
8 Antibody Treponema pallidum antibody in a Antibody Measurement
C92238 Trichomonas Trichomonas Examination of a biological Trichomonas Screening

specimen to detect the presence
of any protozoan belonging to the
Trichomonas genus.
C10042 Tricyclic Antidepressants Tricyclic Antidepressants A measurement of tricyclic Tricyclic Antidepressant

0 antidepressants in a biological Measurement
specimen.
C64812 Triglycerides Triglycerides A measurement of the Triglyceride Measurement

triglycerides in a biological
specimen.
C12118 Triglycerides/HDL Triglycerides/HDL Cholesterol A relative measurement (ratio or Triglycerides to HDL

3 Cholesterol percentage) of the triglycerides to Cholesterol Ratio
high density lipoprotein cholesterol Measurement
C74747 Triiodothyronine Total T3;Triiodothyronine A measurement of the total (free Triiodothyronine

and bound) triiodothyronine in a Measurement
C74748 Triiodothyronine Uptake T3RU;T3U;Triiodothyronine Uptake A measurement of the binding of Triiodothyronine Uptake
triiodothyronine to thyroxine Measurement
binding globulin protein in a
C74787 Triiodothyronine, Free Free T3;Triiodothyronine, Free A measurement of the free Free Triiodothyronine
triiodothyronine in a biological Measurement
specimen.
C81968 Triiodothyronine, Reverse Triiodothyronine, Reverse A measurement of the reverse Reverse Triiodothyronine
triiodothyronine in a biological Measurement
specimen.
C74756 Triple Phosphate Crystals Triple Phosphate Crystals A measurement of the triple Triple Phosphate Crystal
phosphate crystals present in a Measurement
C14727 Triticum aestivum Antigen Bread Wheat Antigen IgE Antibody;Triticum A measurement of the Triticum Triticum aestivum Antigen
7 IgE Antibody aestivum Antigen IgE Antibody aestivum antigen IgE antibody in a IgE Antibody Measurement
C11132 Troponin Troponin A measurement of the total Troponin Measurement

7 troponin in a biological specimen.
C74749 Troponin I Troponin I A measurement of the actin Troponin I Measurement

binding troponin in a biological
specimen.
C13544 Troponin I Type 1 Slow-Twitch Skeletal Muscle Troponin I;Troponin A measurement of the troponin I Troponin I Type 1
7 I Type 1;ssTnI type 1 (slow twitch skeletal Measurement
muscle) in a biological specimen.
C12763 Troponin I Type 2 Fast-Twitch Skeletal Muscle Troponin I;Troponin A measurement of t

SDTM Terminology

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CDISC SDTM Controlled Terminology, 2018-09-28

Source: NCI EVS Terminology Resources website: http://www.cancer.gov/cancertopics/cancerlibrary/terminologyresources/cdisc

NCI CDISC Submission Codelist Name CDISC Definition Codelist

C141663 A4STR1TC 4 Stair Ascend Functional 4 Stair Ascend test code. No

C141662 A4STR1TN 4 Stair Ascend Functional 4 Stair Ascend test name. No

C100132 ADCTC Alzheimer's Disease ADAS-Cog CDISC Version test code. No

C100131 ADCTN Alzheimer's Disease ADAS-Cog CDISC Version test name. No

C112435 AQ01TC Airway Questionnaire 20 Airway Questionnaire 20 test code. No

C112434 AQ01TN Airway Questionnaire 20 Airway Questionnaire 20 test name. No

C147538 ATLAS1TC ATLAS Clinical ATLAS test code. No

C147537 ATLAS1TN ATLAS Clinical ATLAS test name. No

C101807 AVL01TC ADNI Auditory Verbal ADNI AVLT test code. No

C101808 AVL01TN ADNI Auditory Verbal ADNI AVLT test name. No

C135684 CGGUY1TC Clinical Global Clinical Global Impression test code. No

C135683 CGGUY1TN Clinical Global Clinical Global Impression test name. No

C120989 CPS01TC Child-Pugh Classification Child-Pugh Classification test code. No

C120988 CPS01TN Child-Pugh Classification Child-Pugh Classification test name. No

C120979 CRQ01TC Chronic Respiratory Chronic Respiratory Questionnaire Self-Administered Standardized No

C120978 CRQ01TN Chronic Respiratory Chronic Respiratory Questionnaire Self-Administered Standardized No

C120981 CRQ02TC Chronic Respiratory Chronic Respiratory Questionnaire Self-Administered Standardized No

C120980 CRQ02TN Chronic Respiratory Chronic Respiratory Questionnaire Self-Administered Standardized No

C105132 CSS03TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Baseline/Screening Version No

C105131 CSS03TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Baseline/Screening Version No

C111338 CSS07TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Children's Baseline/Screening No

C111337 CSS07TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Children's Baseline/Screening No

C113848 CSS10TC Columbia-Suicide Columbia-Suicide Severity Rating Scale Pediatric/Cognitively Impaired No

C113847 CSS10TN Columbia-Suicide Columbia-Suicide Severity Rating Scale Pediatric/Cognitively Impaired No

C141661 D4STR1TC Descend 4 Stairs Descend 4 Stairs test code. No

C141660 D4STR1TN Descend 4 Stairs Descend 4 Stairs test name. No

C112437 DS01TC Disease Steps Disease Steps test code. No

C112436 DS01TN Disease Steps Disease Steps test name. No

C150768 EMO1TC Emotion Recognition Emotion Recognition test code. No

C150767 EMO1TN Emotion Recognition Emotion Recognition test name. No

C99079 EPOCH Epoch The name of the EPOCH. Yes

C117991 ESRSA1TC Extrapyramidal Extrapyramidal Symptom Rating Scale-Abbreviated test code. No

C117990 ESRSA1TN Extrapyramidal Extrapyramidal Symptom Rating Scale-Abbreviated test name. No

C103463 ESS01TC Epworth Sleepiness Epworth Sleepiness Scale test code. No

C103462 ESS01TN Epworth Sleepiness Epworth Sleepiness Scale test name. No

C129092 FAC028TC National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C129091 FAC028TN National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C150786 FAC030TC National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C150785 FAC030TN National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C150788 FAC036TC National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C150787 FAC036TN National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C129090 FAC042TC National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C129089 FAC042TN National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C129098 FAC050TC National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C129097 FAC050TN National Comprehensive National Comprehensive Cancer Network/Functional Assessment of No

C111344 FAQ01TC Functional Activities Functional Activities Questionnaire test code. No

C111343 FAQ01TN Functional Activities Functional Activities Questionnaire test name. No

C103467 GAD01TC Generalized Anxiety Generalized Anxiety Disorder - 7 test code. No

C103466 GAD01TN Generalized Anxiety Generalized Anxiety Disorder - 7 test name. No

C106663 GDS01TC Geriatric Depression Geriatric Depression Scale test code. No

C106662 GDS01TN Geriatric Depression Geriatric Depression Scale test name. No

C115390 HAI01TC Hauser Ambulation Hauser Ambulation Index test code. No

C115389 HAI01TN Hauser Ambulation Hauser Ambulation Index test name. No

C101867 LEADSTAT Lead Status The status of the lead. Yes

C100142 MMS1TC Mini-Mental State Mini-Mental State Examination test code. No

C100141 MMS1TN Mini-Mental State Mini-Mental State Examination test name. No

C115406 MPAI1TC Mayo-Portland Mayo-Portland Adaptability Inventory-4 test code. No

C115405 MPAI1TN Mayo-Portland Mayo-Portland Adaptability Inventory-4 test name. No

C100144 NPI1TC Neuropsychiatric The Neuropsychiatric Inventory test code. No

C100143 NPI1TN Neuropsychiatric The Neuropsychiatric Inventory test name. No

C120993 NSA01TC Negative Symptom Negative Symptom Assessment-16 test code. No